EP378: The Status of Telehealth Reimbursement and Other Telehealth Policy Updates, With Josh LaRosa, MPP

Where Telehealth Reimbursement Policy Stands Right Now, With Josh LaRosa, MPP. Payment Parity, State Licensure, and the FFS Debate Hiding Inside Telehealth Policy. Episode 378.

Stacey Richter talks with Josh LaRosa, MPP, vice president at Wynne Health Group, about the near-term future of CMS telehealth reimbursement and licensure flexibilities—and why the telehealth coverage debate is really a proxy for the larger fee-for-service versus value-based payment argument.

WHAT YOU'LL LEARN

✅ Why Medicare currently has payment parity between in-office and telehealth visits, and what determines how much longer that lasts

✅ What pandemic-era telehealth "flexibilities"—including across-state-line licensure—are still in effect and which are at risk of expiring

✅ Why telehealth utilization concerns in a fee-for-service model don't apply the same way inside capitated or risk-based arrangements

✅ How the telehealth reimbursement debate is really a subset of the bigger FFS-versus-value-based-payment debate, not a standalone policy question

✅ Why patient safety concerns around telehealth fraud change shape once a practice isn't automatically paid more for doing more visits

✅ How individual states are shaping their own telehealth policy, using Arizona as a specific example

WHY THIS MATTERS

Telehealth coverage decisions often get discussed as if they're self-contained, but LaRosa's framing shows they're inseparable from the broader question of whether the underlying payment model is fee-for-service or value-based—and that context changes what "overuse" or "fraud" risk even means. Understanding where CMS reimbursement policy stands right now helps provider organizations and plan sponsors plan around genuine near-term uncertainty instead of outdated pandemic-era assumptions.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction.

04:09 What is the story with telehealth policy right now?

06:08 What kind of flexibilities did HHS allow with telehealth after the pandemic?

09:46 Are we still under these pandemic flexibilities for telehealth?

12:15 Why isn't the government just making greater access to telehealth permanent?

18:24 How does telehealth lend itself to the risk of overspending when dealing with an FFS model?

21:13 Does telehealth fit into the new CMS fee schedule?

22:55 How do states factor into the future of telehealth?

24:40 What is Arizona doing specifically to improve and ensure the future of telehealth?

30:56 What's next in store for telehealth at the congressional level?