Resources & Reports

Given the robust amount of content provided in the CCHP newsletter last week (July 16, 2024 edition), some readers may have missed a Change Request to the CMS Manual System issued by the Centers for Medicare and Medicaid Services (CMS) in June that went into effect July 8, 2024.  Change Request 13582, Billing and Payment for Telehealth Services with Place of Service (POS) 10 was directed at the Medicare Administrative Contractors (MAC).  MACs are entities that have a contract with CMS to process Medicare Part A and Part B claims for certain territories. When a claim is submitted to Medicare, it goes through the MAC covering the area where the claim is made.  MACs receive instructions and information from CMS regarding relevant policies, including Change Request 13582, which is specific to the use of POS 10.

CCHP’s July Newsletter is here! This month’s topics include – CMS Proposes 2025 Physician Fee Schedule, Strives to Preserve Telehealth Flexibilities Amid Statutory Constraints; Regulatory Crossroads: Past, Present and Potential Future – Telemedicine Controlled Substance Prescribing Amid Fraud Concerns; CMS Clarifies Rate for Place of Service Code 10 in Manual; Medicaid and CHIP Services Bulletin on Enhancing Mental Health and Substance Use Disorder Treatments through Health IT; An Update on Federal Legislation to Extend (or Make Permanent) COVID Medicare Telehealth Flexibilities; Advancing Personalized Care with Remote Patient Monitoring and AI; AMA CPT Editorial Panel Meeting Stalls Changes to Remote Patient Monitoring Codes; FCC’s Net Neutrality Rules Face Legal Challenges Ahead of July 22 Implementation; Latest Policy Developments in CCHP’s Telehealth Policy Finder and Policy Trends Map; Environmental and Health Benefits of Decentralized Cancer Care: Telehealth’s Impact. 

Provider licensure exceptions particular to the use of telehealth across state lines continues to be a popular issue area for those reaching out to CCHP for technical assistance. Questions are received from providers and patients alike, and often providers ask for a list of specific states that currently allow out-of-state providers to deliver care via telehealth to in-state patients for their specific profession. In this week’s write up, we would like to drill down on this area of telehealth policy in the hopes of painting a clearer picture.

On June 13^th the U.S. Department of Justice (DOJ) announced a federal health care fraud indictment against the founder and CEO of Done Global Inc., as well as the company’s clinical president, alleging the individuals were conspiring to commit health care fraud, amongst other charges. The issue has put the currently waived in-person requirements related to controlled substance prescribing in the spotlight due to the fact that the company was focused around Adderall (which is a Schedule II controlled substance) and other stimulant prescribing via telehealth.