{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"EP378: The Status of Telehealth Reimbursement and Other Telehealth Policy Updates, With Josh LaRosa, MPP","description":"Okay, so \u2026 telehealth for Medicare patients. Currently, there\u2019s payment parity, meaning a clinician gets paid the same amount for a Medicare patient visit regardless of whether that patient comes in the office or has a telehealth encounter. Right? Or did that end already? And if it didn\u2019t end, how much longer will payment parity continue? Also, is it the same for commercial and Medicaid patients? Congress makes rules for Medicare patients, but is it Congress that makes the rules for commercial and\/or Medicaid telehealth reimbursement rates? Or how do those reimbursement decisions get made? What about the doing telehealth across state lines thing \u2026 the idea that if I\u2019m a doc in New York, I can take a telehealth appointment with a patient in Arizona even though I am technically not licensed in Arizona? And who\u2019s in charge of that? Yeah, I went into today\u2019s conversation with Josh LaRosa, VP at Wynne Health Group, with a lot of questions. As you may suspect, this program is about telehealth. But just to level set on what we\u2019re not talking about, this interview does not dissect the \u201cshould we use the telehealth or should we not\u201d question; and it does not get into best practices or equity concerns. For that info, listen to the show with Christian Milaster (EP320) or Liliana Petrova (EP357) or Ali Ucar (EP362) or Ian Tong, MD (EP347).  Also, we are not talking about the politics, per se, of who\u2019s for telehealth and who\u2019s against it. We also aren\u2019t drilling too far into the telehealth fraud cases that are coming to light right now, but of course we cannot resist talking about them a little bit. So, let me tell you what Josh LaRosa and I are, in fact, talking about in this healthcare podcast. We\u2019re specifically discussing the near-term future of CMS reimbursement for telehealth and the allowed so-called \u201cflexibilities\u201d for telehealth. We talk about a few of the why\u2019s behind why are policy makers doing some of the stuff that they are doing. And then we chat about the when, how long some of the new flexibilities and reimbursements that were permitted originally during the pandemic will continue. We touch on the Cerebral incident (I guess maybe you\u2019d call it) and the potential DEA or legislative actions that may result from that as well. An interesting point that we dig into for a couple minutes is this one: Do not forget that the whole telehealth reimbursement debate (do I wanna call it?)\u2014Should we cover it? Should we not cover it? And for how much?\u2014this whole debate is part of a bigger debate. A much bigger debate, actually: the fee-for-service vs the not-fee-for-service debate. That\u2019s the larger context of all of this, and I think it\u2019s often overlooked. Nobody anywhere is limiting how often a practice who wants to use telehealth as part of some kind of risk-based or capitated thing can use telehealth. Why? Because in a capitated or bundle arrangement, from a Medicare trust fund perspective at least, telehealth visits are not equivalent to additional spend or additional volume. In a non-FFS environment, there\u2019s little chance of fraud also, really. Also, patient safety\u2014arguably, probably\u2014becomes much more of a practice concern. It gets a lot less rewarding to do unsafe things over telehealth when you don\u2019t get automatically paid to do them \u2026 and also paid to fix the problems that resulted from the unsafe things, which is the perverse beauty of FFS that we\u2019re all so familiar with. Acronym alert! PHE stands for public health emergency. A public health emergency is the thing the government declares, for example, during a pandemic. You can learn more at wynnehealth.com or by following on Twitter and LinkedIn.   Josh LaRosa, MPP, is a vice president at Wynne Health Group, focusing primarily on regulatory affairs with a focus on the US Food & Drug Administration (FDA) and Centers for Medicare & Medicaid Services (CMS). His interests lie in delivery reform and innovations in payment and care delivery models. Josh also supports the firm\u2019s Public Option Institute, which studies the emergence of public option programs at the state level. Prior to Wynne Health Group, Josh consulted for the CMS Innovation Center, where he worked to implement, monitor, and spread learning garnered from the center\u2019s high-profile demonstration projects, most recently including the national primary care redesign effort, Comprehensive Primary Care Plus (CPC+). Josh holds a Master of Public Policy from the University of Virginia\u2019s Frank Batten School of Leadership and Public Policy. He also completed his undergraduate studies at the University of Virginia, graduating cum laude with a BA in political philosophy, policy, and law. 04:09 What is the story with telehealth policy right now? 06:08 What kind of flexibilities did HHS allow with telehealth after the pandemic? 09:46 Are we still under these pandemic flexibilities for telehealth? 12:15 Why isn\u2019t the government just making greater access to telehealth permanent? 18:24 How does telehealth lend itself to the risk of overspending when dealing with an FFS model? 21:13 Does telehealth fit into the new CMS fee schedule? 22:55 How do states factor into the future of telehealth? 24:40 What is Arizona doing specifically to improve and ensure the future of telehealth? 30:56 What\u2019s next in store for telehealth at the congressional level? You can learn more at wynnehealth.com or by following on Twitter and LinkedIn.   @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth What is the story with telehealth policy right now? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth What kind of flexibilities did HHS allow with telehealth after the pandemic? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth Are we still under these pandemic flexibilities for telehealth? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth Why isn\u2019t the government just making greater access to telehealth permanent? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth How does telehealth lend itself to the risk of overspending when dealing with an FFS model? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth Does telehealth fit into the new CMS fee schedule? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth How do states factor into the future of telehealth? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth What is Arizona doing specifically to improve and ensure the future of telehealth? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth What\u2019s next in store for telehealth at the congressional level? @josh_larosa of @WynneHealth discusses #telehealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth   Recent past interviews: Click a guest\u2019s name for their latest RHV episode! Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas, David Muhlestein, David Scheinker, Ali Ucar, Dr Carly Eckert, Jeb Dunkelberger (EP360), Dan O\u2019Neill, Dr Wayne Jenkins, Liliana Petrova, Ge Bai   ","author_name":"Relentless Health Value","author_url":"https:\/\/relentlesshealthvalue.com","html":"