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Telephone medical services covered by Medicare now

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A change in a federal rule will make it easier for many New Mexicans to have their medical care covered by Medicare during the coronavirus situation.

Federally qualified health centers and rural health clinics asked for a change in the rule about how telemedicine services are covered by the Centers for Medicare and Medicaid Services (CMS). That included La Casa Family Health Center, which covers several southeastern New Mexico cities and serves Eastern New Mexico University-Roswell.

They wanted telephone consultations covered in addition to other telemedicine services.

On March 27, the passage of the Coronavirus Aid, Relief and Economic Security (CARES) Act allowed CMS to authorize Medicare coverage of telemedicine services. But the law only covered services that offered both video and audio interactions between health providers and patients. That hampered people without good internet service, said U.S. Rep. Xochitl Torres Small, who advocated for a rule change along with 19 other congressional representatives.

She said that early in March, federal health clinics and rural health providers discussed how they were having to switch to remote services as an effort to guard against the spread of COVID-19, as well as to conserve their personnel and resources during the crisis.

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“They were telling me about challenges serving patients and specifically reaching patients that didn’t have good, reliable internet to do the telemedicine,” she said. “On that call, it was brought up of the need to be able to provide telephone consultations, like for seniors who are trying to get a prescription refilled.”

She said health care providers felt that telephone consultations made sense in those instances, but current rules did not allow providers to be compensated for that.

She and the other legislators requested the CMS administrator to change the rule in a March 22 letter. While CMS considered the request, New Mexico changed its rules regarding Medicaid’s Children Health Insurance Program (CHIP) so that audio-only medical services are covered by that insurance program, Torres Small said.

CMS made the decision to change the rule May 1 and decided that it would be retroactive to the beginning of the coronavirus emergency. At this point, the rules about reimbursement of telemedicine services are expected to be in effect only through the coronavirus pandemic.

According to the New Mexico Human Services Department, New Mexico had 318,676 children and youth enrolled in Medicaid as of May 1. Chaves County had 12,406. In 2018, New Mexico had 279,212 people enrolled in Medicare, according to the Kaiser Family Foundation.