The GAO performs a study on telehealth.
The U.S. Government Accountability Office (GAO) provides Congress, the heads of executive agencies, and the public with timely, fact-based, nonpartisan information that can be used to improve government and save taxpayers billions of dollars.
For example, the GAO recently determined that from March 2020 to February 2021, a total of 32.5 million services were delivered via telehealth – versus 2.1 million services the prior year. But Medicaid hasn’t collected or assessed data on the quality of care that beneficiaries received via telehealth services.
Per the GAO, Medicaid officials from all six selected states – including Arizona, California, Maine, Mississippi, Missouri, and Tennessee – said expanding telehealth supported beneficiaries’ access to care, but also identified some limitations. Officials reported making or considering post-pandemic telehealth modifications.
What was interesting from this GAO study was that they reported that the Centers for Medicare & Medicaid Services (CMS) “does not collect, assess, or report information about any effect delivering services via telehealth has on the ‘quality of care’ Medicaid beneficiaries receive, and has no plans to do so.” Why is that? From someone who is a proponent of telehealth, as long as it shows that it’s more than a convenient way to deliver healthcare, but also a medically necessary and efficient way to take care of patients (and not just another waste of government spending), its use should be encouraged. This should have been a top priority for CMS.
The GAO further stated that collecting this data is important, given concerns GAO has raised about the quality of care provided via telehealth. It would also be consistent with how CMS has encouraged states to use data on quality of care to identify disparities in healthcare and target opportunities for improvement to advance health equity.
Why did the GAO perform this study?
The Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a provision for the GAO to report on the federal response to the pandemic. In addition, the GAO was asked to examine the use of Medicaid flexibilities in response to COVID-19. This report describes selected states’ telehealth use before and during the pandemic, as well as their experiences with and plans for telehealth. It also evaluates, among other things, CMS’s telehealth oversight of quality of services.
You have to ask the question: “How can you expand telehealth in the Medicaid program if you don’t have all of the data to show it is safe, effective, and accessible – and the quality of care is comparable to an in-person patient visit?” You can’t.
So, the GAO is making two recommendations to CMS: to collect and analyze information about the effect delivering services via telehealth has on the quality of care Medicaid beneficiaries receive, and to determine any next steps based on the results of the analysis.
Does CMS have to follow their recommendations?
| Agency Affected | Recommendation | Status |
| Centers for Medicare & Medicaid Services | The Administrator of CMS should collect and analyze the information needed to assess the effect delivering services via telehealth has on the quality of care Medicaid beneficiaries receive. (Recommendation 1) | Open When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information. |
| Centers for Medicare & Medicaid Services | The Administrator of CMS should determine, based on the results of its initial assessment, whether further assessments of the effect delivering services via telehealth has on the quality of care Medicaid beneficiaries receive are warranted, for the purposes of developing guidance to assist states in making telehealth coverage and payment decisions. (Recommendation 2) | Open When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information. |
Only time will tell.
References:
https://www.gao.gov/products/gao-22-104700
https://www.gao.gov/about/what-gao-does
Literature is ripe with classic phrases that seem timelessly apropos. For example, take the partial federal government shutdown. For days, the phrase repeated in the
The Centers for Medicare & Medicaid Services (CMS) has released a report on the Acute Hospital Care at Home (AHCAH) initiative, a program allowing select
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
