During the height of the pandemic, telehealth quickly became the vehicle of choice for the medical community, and the declaration of a national health emergency gave federal agencies, including Medicare, Medicaid, and private health insurance, increased flexibility in addressing people’s health needs.
The Public Health Emergency (PHE) will soon expire, and with it, most of the provisions set forth in various pieces of legislation will sunset on May 11, 2023.
Today, with its unparalleled convenience and capacity to reach into areas often unserved by traditional medical offices, telehealth continues as a popular option for patients and providers alike. With that the case, it’s important to ask: what will the expiration of the PHE mean for telehealth?
Extending Flexibility
Many of the PHE provisions have impacted Medicare recipients. The declaration expanded, for example, the list of Medicare services that could be covered by patients using telehealth. The PHE also expanded the eligibility of telehealth for Medicare beneficiaries. Prior to the declaration, only Medicare participants in rural areas could access telehealth, but the PHE expanded access to any geographic area. It also enabled those on Medicare to access telehealth from their homes, as opposed to needing to do so from a health care facility.
More recently, Congress passed legislation that would extend certain PHE provisions. The Consolidated Appropriations Act of 2023 continues to allow Medicare beneficiaries to access telehealth from their homes, which is especially important to patients in rural areas who may live more than an hour from any health care facility.
Another area that seeks to extend the life of COVID-era provisions relates to prescribing drugs. During the Public Health Emergency, the Drug Enforcement Administration waived a 2008 requirement that prohibited health practitioners from prescribing certain controlled substances (like Adderall and Ritalin) based solely on a telehealth visit (if the provider had not seen that patient in-person before). A new proposed rule now seeks to make that waiver permanent. It’s a change that proponents say will help ensure access and continuity of care.
Virginia’s Protections
In Virginia, the General Assembly has recognized the value that telehealth has provided and has taken legislative steps to make COVID-related changes more permanent. Legislators have codified the revised rules that were put in place in 2020 so that the Commonwealth “won’t fall off the telemedicine cliff,” as Dr. Karen Rheuban, VTN chair and director and co-founder of the University of Virginia Center for Telehealth, said.
As a result, patients in Virginia will continue to access health care regardless of where they live. That includes maintaining a relationship with an out-of-state provider not licensed in Virginia for up to a year, so long as the provider initially saw the patient in person.
Also continuing is the ability of Medicaid enrollees and certain others with private insurance to get coverage for remote-patient monitoring, services that allow providers to remotely check the health of patients with chronic conditions.
Some pandemic-era rules will not continue. Telehealth platforms that don’t comply with federal restrictions on medical privacy – including FaceTime and Zoom – will not be allowed, nor will commercial insurance coverage continue for some audio-only services.
All in all, it’s fair to say that the post-COVID momentum surrounding telehealth will continue.
Resources to Help Navigate the End of the PHE
To help prepare for the changes that come with the end of the Public Health Emergency, it’s important to understand the timeline of provisions, flexibilities, and changes that will impact provider communications. The following are resources to help you stay up to date.
- Telehealth Services and Virginia’s Medicaid Program – Department of Medical Assistance Services
- Medicare Telehealth / Connected Health Waivers Post-PHE – Center of Connected Health Policy
- Telehealth Policy Changes After the COVID-19 Public Health Emergency – TELEHEALTH.HHS.GOV
- End Of the Public Health Emergency (PHE) Resources – National Consortium of Telehealth Resource Centers
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