How have telehealth regulations changed over the last month? Let’s take a look at the latest legislation, including what bills have been enacted and introduced in March 2022.
Federal Funding Omnibus Bill – Enacted
In addition to funding the government through the end of 2022, this bill extends the Medicare telehealth waivers 151 days (5 months) beyond the end of the public health emergency. This includes:
- Removing geographic requirements and allowing an individual to receive telehealth services wherever they are located (originating site), including the home
- Extending telehealth services for Federally Qualified Health Centers and Rural Health Clinics
- Delaying the in-person requirement for mental health services
- Allowing for audio-only telehealth services
- Use of telehealth to conduct face-to-face encounters before recertification of hospice eligibility
- Expanding eligible practitioners to include occupational, physical, and speech therapists
- No facility fee unless the site meets the original definition of an originating site
Dr. Lorna Breen Health Care Provider Protection Act – Enacted
Designed to improve healthcare workers’ mental health and well-being, this act establishes grants for training healthcare professionals to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders.
The bill also establishes:
- A national education and awareness initiative to encourage healthcare workers to seek support and treatment for mental and behavioral health concerns
- Grants for employee education, peer-support programming, and mental and behavioral health treatment
- A comprehensive study on mental and behavioral health and burnout among healthcare workers, including during the COVID-19 pandemic
Telehealth Treatment and Technology Act of 2022 or the 3T Act of 2022 – Introduced
This bill aims to allow providers with a license in good standing to provide telehealth services to patients in any state, District of Columbia, territory or possession of the United States, or location designated by the Secretary of Health and Human Services (HHS). If a provider already participates in a licensure compact, this provision would not apply.
The bill would allow providers to establish a provider-patient relationship by “written acknowledgment or synchronous technology” when a previous relationship does not already exist.
Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act)
Designed to strengthen federal and state preparedness, a sample of the items includes:
- The establishment of a task force with membership appointed by a bipartisan congressional and Committee leadership to examine the initial emergence of SARS-CoV-2 and the US’ preparedness and response to the COVID-19 pandemic to identify gaps and make recommendations
- Support access to mental health and substance use disorder services during public health emergencies
- Reauthorize two grant programs to improve trauma care through increased coordination and awareness within emergency medical and trauma systems – including identification and dissemination of best practices
- Address social determinants of health and improve health outcomes
- Modernize biosurveillance capabilities and infectious disease data collection
Alabama House Bill 423 – The Practice of Medicine – Passed 1st Chamber and is in 2nd Committee
Introduced on March 1, this fast-moving bill would allow physicians to establish a physician-patient relationship without a prior in-person visit. It would also require “a physician or practice group provides telehealth medical services more than four times in a 12-month period to the same patient for the same medical condition without resolution, the physician shall do either of the following”:
- See the patient in person within a reasonable time, which shall not exceed 12 months
- Appropriately refer the patient to a physician who can provide the in-person care within a reasonable amount of time, which shall not exceed 12 months
- Each pregnancy shall be considered a separate or new condition
- The term “practice group” shall mean, at a minimum, a group of providers who have access to the same medical records
- The Board of Medical Examiners, by rule or otherwise, may provide for exemptions to the requirement that are no more restrictive than the provisions of this article
The definition of telehealth in the bill omits remote patient monitoring.
Louisiana House Bill 826 – Telehealth Access Act Modification Introduced
This bill would add licensed, certified, or registered addiction and compulsive gambling counselors to the definition of “healthcare provider.” It would also allow the Addictive Disorder Regulatory Authority board to make rules that comply with the Telehealth Access Act.
Minnesota House Bill 4705 – Reducing Telehealth Reimbursement Rates – Introduced
This bill would reduce medical assistance coverage of telehealth services to 90% of the reimbursement rate paid for the same in-person treatment.
Vermont House Bill 655 – Telehealth Licensure and Registration – Amended
This bill would establish licensure and registration of out-of-state healthcare providers. It would also define how these providers establish a relationship where one does not already exist.
Of note in the bill, “store-and-forward means an asynchronous transmission of medical information, such as one or more video clips, audio clips, still images, MRI scans, electrocardiograms, electroencephalograms, or laboratory results, sent over a secure connection …”. It also requires that relationships be established synchronously.
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