Comment Letter on CY 2022 Physician Fee Schedule Proposed Rule

The Alliance for Connected Care submitted comments on the Medicare Physician Fee Schedule (PFS) Proposed Rule for calendar year (CY) 2022, which includes several important reforms with respect to telehealth. The Alliance applauds the proposal to retain all Category 3 telehealth codes through the end of Calendar Year (CY) 2023 to provide an opportunity to collect and study data on the telehealth experience during the COVID-19 public health emergency.

In advance of our more detailed response the Alliance emphasized the following overarching priorities:

• A great deal of confusion continues to exist around the authority of the Administration to make longer-term telehealth changes. We encourage CMS to continue clearly communicating to Congress and stakeholders that there are statutory limitations curtailing CMS’ ability to allow continued access to telehealth for Medicare beneficiaries. Additionally, we urge you to continue collecting and publicly sharing data about telehealth utilization and inform a conversation with Congress around what statutory authorities CMS needs to make thoughtful, long-term policy.
• While we appreciate and support CMS’s effort to create temporary category 3 codes and its proposal to retain these codes through the end of the Calendar Year (CY) 2023, we continue to believe these codes are inadequate to the stability and predictability needed for health care providers to make necessary investments and plan for care/care systems in the longer term. Furthermore, and just as important, patients deserve and require predictability in their health care – and we urge CMS to consider patient expectations especially as patients have become more engaged in the delivery of health care services, and have become more ensconced in a hybrid model of health care delivery.
• While we recognize some statutory requirements exist, we remain very concerned with steps taken by CMS around in-person visit requirements. The Alliance and its members strongly believe that an in-person requirement constrains telehealth from helping individuals that are homebound, have transportation challenges, live in underserved areas, etc. It does not constrain those using telehealth for convenience. This creates a perversion of the Medicare payment system by reducing access for those who need it most, while allowing access for others.
• While we are supportive of CMS’ proposals to increase beneficiary participation and access in the Medicare Diabetes Prevention Program (MDPP) Expanded Model, we would like to highlight additional actions that would match CMS’ goals for the program. Specifically, the Alliance strongly feels that CMS should permit any CDC-recognized DPP suppliers to apply to become Medicare suppliers – including virtual DPP suppliers. Not only would permitting virtual suppliers to apply to become MDPP Expanded Model Suppliers increase the number of MDPP Suppliers participating in the program, but it would also broaden the reach of who can receive diabetes prevention services beyond brick-and-mortar locations, and provide convenient and timely access to a more diverse set of patients no longer burdened by needing to take time off everyday demands to complete the required curriculum.