Blog contributed by Mei Kwong, Executive Director of The Center for Connected Health Policy
The highly infectious COVID-19 has people quarantining because they are infected or staying at home to reduce their risk of infection. However, many people still need to access health services not related to the treatment of COVID-19. Telehealth has emerged as one of the vital tools used in addressing our current reality in a COVID-19 world and policymakers are making swift changes to ensure the flexibility to use the technology is there.
Telehealth is the use of technology to provide health services when the patient and provider are not in the same location. It has been in existence for decades and had been slowly gaining acceptance in recent years. There is federal telehealth policy primarily related to Medicare and state telehealth policy addressing Medicaid and private insurance. Pre-COVID-19, each state had different approaches to telehealth policy. Some states had more expansive policies such as covering most services in their Medicaid program if telehealth was used to another Medicaid program only allowing it only for certain specialties such as mental and behavioral health services. In the COVID-19 world, this has changed dramatically. While state policies do still vary, there are themes that have emerged on the state level. Below are a few of the most common changes that have been enacted in this emergency situation:
- Allowing the home to be an eligible site for the patient to receive services – Prior to COVID-19, in many Medicaid programs the home was an ineligible site for telehealth-delivered services or it would be allowed in limited circumstances. Dropping this barrier is one of the most frequent changes states have made. Given the multiple stay-at-home orders and the desire to limit contact to stop the spread of COVID-19, it is easy to understand why so many states have adopted this change.
- Allowing the telephone to be used to provide services – Most states explicitly exclude the use of phone, along with email and fax, as being a part of telehealth either in statute or policy. However, recognizing that some may not have access to telehealth technologies, policymakers are allowing the telephone to be used as a means to provide services.
- Easing privacy and health information protections – The federal government was the first to ease protections by stating that the Office of Civil Rights would not be fining Health Insurance Portability and Accountability Act (HIPAA) violations. However, this action did not impact state laws around such issues, though some states have followed suit with relaxing some of their privacy protections.
These are only a few of the more common changes being seen on the state level with regards to telehealth policy. Each day brings new developments and some states, depending on where they were in their policies pre-COVID-19, had to make more changes than others. When the current crisis passes, hopefully, telehealth would be recognized as the valuable tool that providers should have in their toolkit and some of these changes will remain after the emergency.
This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement number U30CS16089, Technical Assistance to Community and Migrant Health Centers and Homeless for $6,375,000.00 with 0% of the total NCA project financed with non-federal sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.