CMS: HHS extends risk adjustment for telehealth, telephone COVID-19 services

Editor's Note

On April 29, the Centers for Medicare & Medicaid Services (CMS) updated an April 2020 “Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs” notice to extend telehealth and telephone-only services in the Department of Health and Human Services (HHS) risk adjustment program, the American Hospital Association (AHA) May 2 reports.

With Affordable Care Act authorization, AHA noted, the risk adjustment program transfers funds from plans with low-risk enrollees to plans with high-risk enrollees to “help stabilize premiums for non-grandfathered plans in the individual and small group markets.”

With the ongoing pandemic still requiring providers to expand the use of telehealth and virtual care options, HHS will continue to include select telehealth and telephone-only services in its risk adjustment program for qualified health plans in 2022.

Access the updated FAQ sheet from CMS here.