CMS Proposed Rule on Medicare Coverage Policy

Seema Verma, MPH, Administrator
Centers for Medicare & Medicaid Services (CMS)

Department of Health and Human Services (HHS)

Re. File Code CMS–1734-P
Proposed Rule on Medicare Program; CY2021 Payment Policies and Other Policy Changes

 

October 2, 2020

Dear Administrator Verma,

American Epilepsy Society (AES) is the professional society for approximately 4,000 healthcare professionals committed to epilepsy research and the care of individuals afflicted with epilepsy. In response to the above-referenced CMS Proposed Rule, attached please find the AES Telehealth Position Statement in which AES outlines its recommendations and rationale related to the telehealth provisions of the Proposed Rule that impact care of people with epilepsy.

In short, because flexibility in telehealth care delivery options enables optimal care for people with epilepsy, AES supports:
  • Continuation of telehealth as an option for epilepsy care following the COVID-19 pandemic
  • Reimbursement parity for care provided via in-person visits, via video-audio telehealth, and via audio-only telehealth visits, and equitable reimbursement for unscheduled care via telephone call or email.
  • Continued ability for epilepsy care providers to write prescriptions for controlled substances used as epilepsy treatments to be written based on a telehealth visit, without a prior in-person visit between the prescriber and the patient
  • Telehealth reimbursement for multi-disciplinary epilepsy care team providers who collaborate to provide the most efficient and effective care (physicians and non-physician providers, including nurse practitioners, clinical nurse specialists, clinical pharmacists, physician assistants, neuropsychologists, clinical psychologists, social workers, dietitians, genetic counselors)
  • Streamlined provider licensing among states and medical liability insurance covering telehealth services
  • Education to enable providers to optimize use of telehealth technologies in epilepsy care
  • Continued development of telehealth workflows and technologies that incorporate epilepsy care tools such as psychosocial and quality of life assessments, stimulator technologies, wearable devices for seizure detection or forecasting, and other remote monitoring/mobile health technologies


AES is dedicated to improving the lives of people with epilepsy. We believe that, as demonstrated during the COVID-19 pandemic, and with technological advancements enabled by telehealth on the near horizon, facilitating use of telehealth in epilepsy care has great potential to effect significant improvements in epilepsy care and enhance the lives of people with epilepsy.

Extension of the COVID-19 provisions for flexible options and reimbursement support for providing care via telehealth is particularly critical for patients with epilepsy and their health care providers, as outlined here and detailed in the AES Position Statement.

AES appreciates the opportunity to provide comments. We remain available to answer questions, provide additional information, offer clinical or scientific expertise, or otherwise serve as a resource to CMS.

Sincerely,

William Davis Gaillard, MD
President, American Epilepsy Society

AES President
PRESIDENT
William Davis Gaillard, MD
Chevy Chase, MD
FIRST VICE PRESIDENT
Douglas A. Coulter, PhD
Philadelphia, PA
SECOND VICE PRESIDENT
R. Edward “Ed” Hogan, MD
St. Louis, MO
PRESIDENT EMERITUS
Page B. Pennell, MD
Boston, MA
TREASURER
Howard P. Goodkin, MD, PhD
Charlottesville, VA
BOARD MEMBERS
Sheryl C. Haut, MD
Bronx, NY
Manisha N. Patel, PhD
Aurora, CO
Elinor Ben-Menachem, MD, PhD
Goteborg, Sweden
Lori L. Isom, PhD
Ann Arbor, MI
Kevin E. Chapman, MD
Aurora, CO
Barbara A. Dworetzky, MD
Boston, MA
EXECUTIVE DIRECTOR EX-OFFICIO
Eileen M. Murray, MM, CAE
Chicago IL