The Next Chapter in Telemedicine

September 23, 2021

Doctor appointments and visits were cancelled or postponed during the height of the COVID-19 pandemic, propelling telemedicine to the forefront as a viable and necessary alternative, including in home health care. The overall use of telehealth, in fact, surged by more than 3,000 percent when comparing October 2020 data to the same month the year prior, according to nonprofit Fair Health.

The Centers for Medicare & Medicaid Services (CMS) facilitated the utilization of telemedicine during the pandemic with its emergency waiver in March 2020, which added more than 80 new telemedicine services to the list of services covered by Medicare and reiterated that all connected health services are now reimbursed at the same rate as in-person services. The CMS also temporarily waived rules requiring licensed clinicians to hold a valid license in the state where their patient is located. As a result, most states temporarily changed their licensing requirements for doctors, so that a physician in one state could diagnose a patient in another state.

This is now changing.

States Are Rolling Back Telemedicine Licensing Waivers

States have begun to roll back pandemic workarounds, which could potentially mean the ability to conduct certain virtual appointments may be coming to an end, according to a recent article in Kaiser Health News (KHN). Only about 17 states still have waivers in effect, according to the Alliance for Connected Care, a lobbying group representing insurers, tech companies, and pharmacies. The rollbacks, says the article, “come amid a longer and larger debate over states’ authority around medical licensing that the pandemic—with its widespread adoption of telehealth services—has put front and center.”

State boards want to maintain their authority, saying that the power to license and discipline medical professionals boosts patient safety. Note: licensing is also a source of state revenue.

Some States Have Extended Waivers

The call for flexibility in order to continue to provide telemedicine services is being heard and some states are taking action. For example, Arizona made permanent the rules allowing out-of-state medical providers to practice telemedicine for its residents, as long as they register with the state and their home-state license is in good standing. Connecticut’s similar rules have now been extended until June 2023. 

Some advocates are calling for the federal government to enact more sweeping changes and to back legislation pending in the Congress that would temporarily allow medical professionals licensed in one state to treat—either in person or via televisits—patients in any other state.

Working Models for the Future of Telemedicine

In the meantime, voluntary interstate pacts have gained attention, cites the KHN article. For example, separate pacts already exist for nurses, doctors, physical therapists, and psychologists. Proponents say these pacts help ensure state boards retain authority and high standards, while making it easier for licensed medical professionals to expand their footprint. The Nurse Licensure Compact, enacted in 38 jurisdictions, allows registered nurses with a valid license in one state to have it automatically recognized by all the others in the pact. The Interstate Medical Licensure Compact, enacted by 33 states, plus the District of Columbia and Guam, and has issued more than 21,000 licenses since it began in 2017, facilitating the paperwork process, while keeping the cost of applying for licenses in each state intact.

Demand for Telemedicine Necessitates Solutions

The bottom line: Consumers have now grown accustomed to telehealth visits, even though these visits have dropped somewhat since the peak of the pandemic. A July 2021 report by consulting firm McKinsey indicates that “telehealth appears poised to stay a robust option for care. Strong continued uptake, favorable consumer perception, and strong investment into this space are all contributing to this rate of adoption.” With this in mind, the federal and state governments along with providers and payors need to work together toward finding solutions that help foster innovation, competition, and regulatory compliance to create greater access and quality care, improved patient outcomes, and a more efficient healthcare system with telemedicine in the mix.

Manchester Specialty Programs specializes in providing agents and brokers with totally integrated business insurance solutions to meet the needs of Home Care, Allied Health and Human/Social Services organizations. For more information about how our products and services can help protect your insureds, please contact us at 855.972.9399.