E-Consult POLICY: Federal
The federal Centers for Medicare and Medicaid Services (CMS) is a primary driver of health policy, as Medicare is the single largest payer in the country. CMS additionally impacts health policy as the agency overseeing state Medicaid programs. To support e-consult pilots in safety net care settings, many states have used Medicaid Waiver and State Plan Amendments approved by CMS. As these e-consult programs transition from pilot to spread, they provide evidence of e-consult’s ability to support state alignment with federal Medicaid policies by increasing timely access to specialty care and expanding network adequacy. While policy enables states to implement e-consult for safety net care, e-consult supports states’ ability to maintain alignment with federal Medicaid policy guidance.
The E-Consult Workgroup advocates for federal policies, such as the 2019 Medicare Physician Fee Schedule, because of their impact on state policies to increase adoption and implementation of e-consult for safety net providers, payers and patient populations. Ensuring that e-consult policy continues to progress at the federal level requires continued advocacy work.