This article from Bloomberg Law discusses some of the ways federal and state privacy, security and reimbursement rules have changed to accommodate telehealth and expand access to services during the pandemic, and discusses some of the steps health systems will need to take to sustain those services once the waivers expire.
HHS loosened the privacy, security and reimbursement rules that allowed health care providers to expand their use of services like Zoom, FaceTime, Skype and the like to meet with patients. They also loosened restrictions on providers treating patients across state lines, and dropped barriers to care by allowing the waiver or reduction of patient out-of-pocket cost-sharing (deductibles, coinsurance, copayments). Collectively, these measures allowed patients to stay safe, be met where they were, and helped reduce nonemergent patient traffic at hospitals and doctors’ offices.
Federal regulators are in the process of assessing these rules and considering what components might remain as part of long-term policies.
To allow the gains in access to care brought about via telemedicine use to continue, states will have to take certain steps, including:
- Updating and streamline licensure rules for out-of-state providers. This can be done either by allowing credentialing by proxy, or through states joining the Interstate Medical Licensure Compact, which will allow providers licensed by one state to practice in other states that have joined the compact. Indiana has passed the compact but its implementation in the state by the state medical board is categorized as “In Process or Delayed,” according to the Interstate Medical Licensure Compact website.
- Health systems will need to make sure that they sign business associate agreements with the app service providers to make sure they meet health security rules and appropriately protect patient data, including notes, treatments, and lab reports. The AMA, while not endorsing particular platforms, “encourages physicians to use technology with end-to-end encryption like Skype and FaceTime.”