Okay, everyone, my daughter is standing here, so I asked about the visit requirements. She is a phone triage and ER nurse for a large health system who studies the rule changes, often interprets them for her own coworkers.

The doctors are not making this up, although some may not yet understand the new rules completely. Here's the deal, Centers for Medicare and Medicaid Services (CMS) has a whole bunch of new regulations. These came out of findings that a lot of doctors were routinely renewing prescriptions for patients whom they had not actually seen or examined in years (yep - years.)

These include:
Mandatory in person visits annually. A telehealth visit counts the same as in person, except labs still need to be drawn per new regs.
Mandatory lab draws for certain medications. Cholesterol meds every 6 months, some BP meds every 3 months, other meds may have their own requirements.
To refill any medication for blood pressure, or any that may affect blood pressure, they must have a record of an in-office blood pressure check within a specific time frame. If you have had a non-illness, non-emergency visit within your system, your PCP can use that reading.

What does this mean for you? You may be required to get labs drawn for certain meds, even though it wasn't required before. An annoyance for sure, but as we all know, drugs long thought "safe" can cause problems over time. You may need to go in, at least once or twice a year for a BP check. According to my daughter, this can be just a nurse visit, or when you go for labs or a vaccine.

As with all new rules, there is going to be a HUGE learning curve for doctors, their staffs, the insurance companies and all of us. I am going to ask the Connect moderators to see if we can get Mayo to make us an explanatory video, but keep in mind that each PCP, each health system, and each insurance company will be interpreting these rules their own way!

Sue