Telehealth Regulations: What’s In, What’s Out

As the pandemic continues into the winter months and COVID disruptions continue to affect the healthcare workforce, states, payers, and providers should be aware of recent changes that will affect telehealth services and access to telemedicine. Providers and payers should pay attention to the following updates on both the state and federal level.

State-Level Changes Affecting Telehealth Services

Alabama

The State of Alabama state of emergency Proclamation by the Governor which extended the public health emergency until Oct. 31, 2021, has been allowed to expire. This public health order included:

• Emergency care in hospitals
• Practice by out-of-state practitioners
• Expanding capacity of healthcare facilities
• Alternative standards of care

Indiana

The Indiana Executive Order 21-28 was passed to extend the public health disaster emergency only until Dec. 1, 2021. Under state law, this can be extended 30 days at a time. Indiana providers should check in regularly to verify any monthly changes.

Louisiana

The Louisiana Extension Of Emergency Provisions Due To Covid-19 Public Health Emergency was passed but only extends the public health emergency until Nov. 24, 2021. This proclamation speaks to out-of-state medical professionals, ambulance staffing requirements, physicians’ assistants, collaborative practice requirements, and much more. Any practitioners providing care in Louisiana should stay abreast of changes this may cause in the way they provide telehealth services.

States Extending Payment Parity for Telehealth Services

Payment parity requires that telehealth services be reimbursed at the same rates as in-person visits. During COVID, telehealth rates surged all over the country and consequently, many states temporarily implemented payment parity as part of their emergency declarations. Now, many states are making those payment parity laws permanent. The states which have implemented payment parity laws include:

• Arizona
• Alaska (for mental health services only)
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Georgia
• Illinois (expires Jan. 1, 2028)
• Kentucky
• Massachusetts (for mental health services only)
• Missouri
• Montana
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• Oklahoma (effective Jan. 1, 2022)
• Oregon
• Rhode Island
• Utah
• Vermont (expires Jan. 1, 2026)
• Washington

Federal Regulations Affecting Telehealth

Three major federal-level changes in regulation will continue to affect access to telehealth services:

1. The U.S. Department of Health and Human Services (HHS) announcement that renewed the Public Health Emergency (PHE). 

On Oct. 15, 2021, HHS renewed the determination of a PHE for another 90 days which extends to Jan. 15, 2022. This renewal also affects the regulations extending flexibility and funding linked to the PHE.

2. The Federal Communications Commission (FCC) approved nearly $42 million in funding for the COVID Telehealth Program. 

On Aug. 26, 2021, the FCC approved awarding almost $42 million to healthcare providers. This awarded funding will continue to be allocated to reimbursement for telecommunication services, information technology, and devices required to enable telehealth.

3. The Biden Administration committed $19 million to expand telehealth to rural and underserved communities.  

Overseen by the Health Resources and Services Administration (HRSA), $19 million has been allocated to strengthen telehealth services in rural and underserved communities. The $19 million will be used for information programs and services to expand access to telehealth in the following areas:

• $4.2 million will be awarded through the Telehealth Technology-Enabled Learning Program (TTELP) to nine organizations to develop telementoring programs.
• $4.55 million will be awarded through Telehealth Resource Centers (TRCs) to provide information, assistance, and education to providers seeking to deliver care via telehealth.
• $3.85 million will be awarded through the Evidence-Based Direct to Consumer Telehealth Network Program (EB THNP) to 11 organizations to help health networks improve access to telehealth services and assess effectiveness.
• $6.5 million will be awarded through Telehealth Centers of Excellence (COE) to two organizations to evaluate telehealth strategies and services specifically for rural medically underserved communities.

Additional Resources for Telehealth Data for Providers

Regulators and policymakers base decision-making on a variety of sources, including reports by federal and peer-reviewed organizations such as the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) and the Journal of the American Medical Association (JAMA). In order to stay updated on providing premium patient care via telehealth, providers should also review these reports as updated telehealth studies are recently emerging due to the pandemic.

Recent HHS-OIG and JAMA Reports and Findings

On Oct. 21, 2021, HHS-OIG reported finding that 84% of Medicare beneficiaries received telehealth services from providers with whom they already had an established relationship.

In Oct. of 2021, JAMA published a study evaluating the association between the growth of virtual care and healthcare in an integrated delivery network and found that COVID caused in-person visits to decline and virtual services to increase, with no significant change in the overall use of healthcare services. This study suggests that while COVID caused in-person visits to decline and virtual services to increase, there was no significant change in the overall use of healthcare services with evidence that virtual care was substitutive, rather than additive in the ambulatory care setting.

In Sept. 2021, HHS-OIG released two telehealth reports focusing on telemental health delivery through managed care organizations. One is a report from states on challenges while using telehealth to provide behavioral health services. The other reports the opportunities to strengthen oversight and evaluation of telehealth for behavioral health.

How to Remain Compliant With Changing Telehealth Regulations

Staying up to date and taking advantage of resources can be difficult for providers who are already under excess strain due to the pandemic. It is also a challenge for administrative staff to keep up with the changing regulations and best practices in telemedicine, which are changing almost monthly.

Verisys regularly publishes updates on changes to state and federal regulations. Contact us today to stay compliant.

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