On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
Virtual Care Post-Apex: Rethinking Telehealth Policy After the COVID-19 Surge
As COVID-19 has spread across the country, telehealth has proven to be an essential tool for maintaining access to health services while conforming with social distancing restrictions and reducing unnecessary exposure risk for health care providers and consumers. Nearly all states have, in some way, expanded coverage or reimbursement for telehealth services on a temporary basis during the COVID-19 pandemic and nationally, telehealth visits now account for 10 – 20 percent of overall outpatient utilization. As the first COVID-19 apex passes, state Medicaid programs are now grappling with how to maintain access to telehealth services in a severely budget-constrained environment. States are also considering issues related to telehealth coverage and reimbursement requirement in the commercial market, cross-state licensure flexibilities, consumer uptake of telehealth, and address technology access issues for historically underserved populations. Furthermore, by connecting underserved populations to necessary and timely health care, telehealth can be a tool to advancing health equity; as states continue to address health equity issues, it is important for states to consider ways to maintain access to telehealth services in a manner that ensures a more equitable health care system for all.
On Friday, June 12, State Health & Value Strategies hosted a webinar during which experts from Manatt Health and Georgetown reviewed the current telehealth policy landscape and considerations for states as they design their post-apex telehealth policies. This webinar also included brief remarks by state officials from Colorado and Massachusetts.