In light of the ongoing Covid-19 pandemic and nationwide social distancing measures, telehealth services are more popular and many federal and state barriers have been removed in an effort to limit in-office physician visits and promote the continued access to care during the pandemic.
State and federal governments have temporarily relaxed laws surrounding telehealth services. Prior to the pandemic, these services faced several barriers, namely limited insurance coverage, privacy and security concerns, state licensure requirements, and provider reimbursement arrangements.
The Centers for Medicare & Medicaid Services expanded telehealth coverage and waived copayments for certain services for individuals with Medicare and Medicaid plans. According to CMS’ telemedicine health-care provider fact sheet, Medicare will cover office, hospital and other visits furnished via telehealth platforms nationwide, including care provided by doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers.
As a result, there has been more flexibility in offering health-care consultations and services across telehealth platforms. Medicare members are offered a wider range of services, such as mental health counseling and various preventive health screenings, from physicians without attending an in-office visit.
Similarly, private health insurance carriers that provide individual and group health coverage have also expanded their telehealth benefits in response to the Covid-19 outbreak.
Following the federal government’s lead in the expansion of telehealth benefits, state governments have temporarily modified laws surrounding telehealth practices by loosening licensure and portability requirements, allowing physicians to practice across state lines via temporary interstate licensure reciprocity.
The Federation of State Medical Boards has reported that, as of May 26, 49 states plus various U.S. territories, including Guam, the Commonwealth of Northern Mariana Islands and Puerto Rico, have modified requirements for telehealth services in response to the coronavirus pandemic. Certain states, like Florida, already allow health-care professionals that hold out-of-state licenses to provide telehealth services so long as the provider registers with the appropriate board and provides health-care services within the applicable scope of practice.
In efforts to accelerate the use of telehealth services and digital health platforms during the Covid-19 pandemic, the Department of Health and Human Services temporarily relaxed regulations under the Health Insurance Portability and Accountability Act (HIPAA). The modified HIPAA privacy rules permit physicians to communicate with patients on various video-conferencing platforms including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom, and Skype.
Additionally, the Department of Justice’s Drug Enforcement Administration has loosened its requirements by permitting licensed physicians to prescribe controlled substances, such as opioids, without an in-person office visit, through telehealth. Due to the loosened requirements under HIPAA and the DEA, health-care professionals are able to connect with patients and provide necessary health-care solutions in the interim.
Anticipating the ‘New Normal’
The use of telehealth services and digital health platforms has eased the transition from traditional in-office visits to video/audio visits. With states re-opening, telehealth services are at the forefront of the nation’s conversation regarding what our “new normal” will be. Even now, cases have continued to rise in various states and the fear of transmitting Covid-19 remains present amidst the general population. Many hospital systems and physician practices are struggling to resume elective surgeries and other “non-essential” medical care, as patients are hesitant to attend in-office physician visits.
Considering our technological developments, it is only natural to implement the use of telehealth services and digital health platforms. If such services continue to be utilized post pandemic, health-care organizations will need to implement the appropriate infrastructure to support telehealth platforms, and continue to educate patients and providers regarding the use of virtual visits.
Additionally, physician practices and hospital systems that continue to provide these services will have to consider long-term solutions to prevent data breaches of protected health information while supporting the need for access to care.
While the question still stands as to whether state and federal governments will reinstate the previous laws and regulations surrounding telehealth, there is no mistaking that the nationwide benefits of telehealth services and digital health platforms have been exemplified during this pandemic. The temporary expansion of telehealth has not only assisted with the prevention of coronavirus spread, but also bridged the gap between people, physicians and health-care systems, promoting the continued access to care.
This column does not necessarily reflect the opinion of The Bureau of National Affairs, Inc. or its owners.
Lindsay Lowe is an attorney at Wolfe Pincavage, a Florida boutique law firm. With a career dedicated to public health and health-care law, Lowe is exceptionally well-versed in health-care-related matters and a variety of transactional, regulatory, and managed care matters. She has represented providers in health-care licensure, fraud, waste and abuse, and compliance matters.