The COVID-19 pandemic saw a dramatic rise in the use of telehealth services, however a new report has highlighted the restrictive telehealth laws of states that have been most affected by the virus. These states include New York, California, Connecticut, Massachusetts, Washington, and New Jersey, which have distinct limitations placed on virtual care services that cross state lines. For instance, these states are not part of any interstate licensing compacts, which would otherwise allow providers from different states to practice with a license from their home state, provided they are in good standing.
The report, created by Reason Foundation, Cicero Institute, and Pioneer Institute, examines all 50 states’ laws regarding telehealth, which encompasses services like teledentistry and telepsychiatry. Unfortunately, it does not include an examination of state Medicaid telehealth policies. Recently, the American Hospital Association, athenahealth, Johns Hopkins Medicine, and Teladoc Health have joined forces to launch a campaign to make telehealth flexibilities permanent, even when the COVID-19 pandemic ends. The Center for Connected Health Policy and the National Conference of State Legislatures assisted in the report’s evaluations.
In the report, it was noted that state laws governing virtual care modalities are somewhat fragmented, creating difficulties for both providers and patients. Arizona, Florida, and Indiana are the only three states that allow all providers to practice telehealth across state lines with a simple registration process. Most states have abandoned the demand that patients must first visit a provider in-person before using virtual care services, with the exception of Tennessee. Alaska and West Virginia still require an in-person visit before certain services can be used virtually. Modality-neutral telehealth services are allowed in the majority of states, which includes synchronous and asynchronous telehealth, store-and-forward services, and remote patient monitoring. Vermont and Iowa are the only two states to limit use of at least one kind of telehealth modality, defining telemedicine as only including live interactive audio and video.
The report reveals that the majority of states permit a broad scope of providers to utilize telehealth, with twenty states allowing nurse practitioners to utilize it without the need of a doctor’s supervision. Moreover, the report includes policy best practices for state policymakers to consider as they chart the course for telehealth, such as enabling all kinds of providers to use telehealth, encouraging interstate telehealth, and promoting “modality-neutral” policies. However, the report does not support payment parity laws that mandate telehealth visits to be paid for at the same rates as in-person care, citing that these laws can be detrimental to “vulnerable patients as they pay more, and small businesses as large companies are not subject to these mandates.”