Is the GAO Holding CMS responsible for the expansion of Medicaid Telehealth?

The GAO is conducting a study on telehealth.

The United States Government Accountability Office (GAO) provides Congress, heads of executive agencies, and the public with timely, factual, and 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, up from 2.1 million services the previous year. But Medicaid did not collect or assess data on the quality of care beneficiaries received through telehealth services.

According to the GAO, Medicaid officials in the six select states — including Arizona, California, Maine, Mississippi, Missouri, and Tennessee — said expanding access to care for supported beneficiaries by telehealth, but also identified some limitations. Officials said they have made or considered post-pandemic telehealth changes.

What was interesting about this GAO study is that they reported that the Centers for Medicare & Medicaid Services (CMS) “does not collect, evaluate, or report information about the effects of service delivery. via telehealth on the “quality of care” Medicaid recipients receive. , and has no intention of doing so. Why so? 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 effective way to care for patients (and not just another waste of government spending), its use must should be encouraged This should have been a top priority for CMS.

GAO further stated that collecting this data is important, given concerns raised by GAO about the quality of care provided via telehealth. This would also be consistent with how CMS has encouraged states to use quality of care data to identify health care disparities and target opportunities for improvement to advance health equity.

Why did the GAO conduct this study?

The CARES Act (Coronavirus Aid, Relief, and Economic Security Act) includes a provision allowing the GAO to report on the federal response to the pandemic. Additionally, the GAO has been asked to review the use of Medicaid flexibilities in response to COVID-19. This report describes some states’ use of telehealth before and during the pandemic, as well as their telehealth experiences and plans. It also evaluates, among other things, the monitoring of the quality of services by CMS telehealth.

You have to ask the question, “How can you expand telehealth into the Medicaid program if you don’t have all the data to show it’s safe, effective, and accessible — and the quality of care is comparable to that of… a patient visit?” You can’t.

Thus, the GAO makes two recommendations to CMS: collect and analyze information on the effect of service delivery via telehealth on the quality of care Medicaid recipients receive, and determine next steps based on the results of the ‘analysis.

Should the CMS follow their recommendations?

Agency concerned Recommendation Status
Medicare and Medicaid Service Centers The CMS administrator must collect and analyze the information necessary to assess the effect of service delivery via telehealth on the quality of care Medicaid beneficiaries receive. (Recommendation 1) Open Once we have confirmed the action taken by the agency in response to this recommendation, we will provide updated information.
Medicare and Medicaid Service Centers The CMS administrator should determine, based on the results of its initial assessment, whether further assessments of the effect of service delivery via telehealth on the quality of care Medicaid beneficiaries receive are warranted, at the purposes of developing guidance to help states make telehealth coverage and payment decisions. (Recommendation 2) Open Once we have confirmed the action taken by the agency 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

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