Experts predict support for some, but not all, telehealth expansion measures

Among the takeaways at this week's Telehealth Innovation Forum: Those hoping for long-term state licensure waivers across the board may be in for disappointment.
By Kat Jercich
10:21 AM

An expert panel convened at Tuesday's Teladoc-sponsored Telehealth Innovation Forum predicted changes to the originating and geographic site requirements for telehealth – but not to state licensure waivers allowing physicians from one state to practice in another.

Although licensure waivers have been of particular importance during the COVID-19 pandemic, Claudia Duck Tucker, vice president of government affairs at Teladoc, predicted that, on that topic, at least, "everything will go back to pre-COVID."

The waivers, which were largely issued by governors' office and boards of medicine, "came with a specific start date and a specific end date," said Tucker. "Some states have extended the life of those, but when the emergency is over, everything will go back to pre-COVID days."

"Healthcare is regulated at the state level … with the exception of federal programs," she explained. "There's no appetite that I've seen with the state boards of medicine or the AMA to relinquish that control" – though, she noted, that's not a bad thing.

Tucker also said that states have learned from the pandemic experience. 

"If we need to do licensure waiver again then the states will respond very quickly," she said.

When it comes to making other changes permanent, Tucker was more optimistic about geographic and originating site rules allowing physicians to be reimbursed for telehealth services provided to a patient at their home. 

Such a permanent change, said Tucker, has "broad support and bipartisan support." 

This past week, a bipartisan group of House representatives introduced the Protecting Access to Post-COVID-19 Telehealth Act, which would eliminate most geographic and originating site restrictions on the use of telehealth in Medicare.

Tucker also predicted that the Centers for Medicare and Medicaid Services would expand some telehealth services eligible for reimbursement, and that broader adherence to HIPAA-compliant software would return after the pandemic.

To that point, Tracy Rico, director of telehealth services for Superior Health Plan (a subsidiary of Centene), said that although she's supportive of expanded access to virtual care, "I want to make sure providers are doing it with the HIPAA-compliant platform" in the future.

"My favorite thing is … we had to tell doctors you can't do telemedicine via TikTok," Rico quipped.

"As a clinician, I understand the value of meeting people where they're at – literally," said Rico.

Rico noted that she's seen claims for telehealth skyrocket during the pandemic, especially for behavioral health. 

"I'm all about the silver lining," Rico added. "If there's a silver lining in COVID, it's telehealth."

Questions also remain about private insurance plans. Last month, Blue Cross Blue Shield of Tennessee announced that it would make permanent coverage of in-network telehealth services. 

BCBS Tennessee SVP and Chief Medical Officer Dr. Andrea Willis said that telehealth "has opened up another opportunity for people to get care in a different way."

"We are continuing this expansion for our commercial population because it feels like it's the right thing to do," Willis continued.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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