# Plain Language Summary: Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021

This bill makes it easier for Medicare Advantage plans and PACE programs (Programs of All-Inclusive Care for the Elderly) to count diagnoses made during phone-only doctor visits when calculating how much money they receive from the government. Here's why this matters: Medicare Advantage plans get paid based partly on how sick their patients are—the sicker the patient population, the more funding they receive. Normally, these diagnoses need to come from in-person visits or video calls. This bill says that for 2020 and 2021, diagnoses from audio-only phone calls can count too, but only if the patient has a chronic condition (like diabetes or heart disease) that was already diagnosed in the previous three years and the doctor calling has treated that patient before.

The bill also requires that during the COVID-19 emergency period, Medicare must pay doctors and clinics the same amount for telehealth services as they would have paid for the same service done in person. This removes any financial penalty for providing care over the phone instead of face-to-face. For example, if a doctor normally gets paid $100 for an in-person visit, they'd get paid $100 for a phone visit too, rather than a lower telehealth rate. This encourages healthcare providers to offer remote care options without losing income, which became especially important during the pandemic when in-person visits weren't always safe or possible.

Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021

Sewell, Terri A.

Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 This bill allows audio-only diagnoses that are made via telehealth to be used for purposes of determining risk adjustments to payments under Medicare Advantage. Additionally, the bill requires payments for Medicare telehealth services that are furnished during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019) to be made in the same amounts as those for in-person services.