The state executives were told that frail patients have come to rely on remote access with their specialist providers, many of whom reside out of state.
More than 230 telehealth stakeholders sent a letter to the nation's 50 governors urging them to keep in place licensure flexibilities enacted at the start of the pandemic for the duration of the federal public health emergency.
"Over the last few months, many states have allowed COVID-19 emergency declarations to expire and the licensure flexibilities to expire with it, despite the ongoing pandemic and surge in cases due to the Delta variant," said the letter, coordinated by the Alliance for Connected Care, the ALS Association, and the National Organization for Rare Disorders.
"This has been extremely detrimental and disruptive to necessary and ongoing patient care," the letter said. "Healthcare providers have had to scramble to notify thousands of out-of-state patients that their telehealth appointments were no longer possible, and that they would have to drive across state borders to keep their appointments."
Among the flexibilities in the March 2020 1135 waiver put forward by the Centers for Medicare & Medicaid Services, states were allowed to waive licensing requirements so that remote providers could offer patient care across state lines. In addition, eligible payments for telehealth services were expanded to include hospital, physician office, and patient home visits, and a range of providers were allowed to bill for telehealth, including nurse practitioners, clinical psychologists, and licensed clinical social workers. Providers were also given the flexibility to reduce or waive cost-sharing for telehealth visits paid for by federal healthcare programs.
The stakeholders told the governors that many patients have come to rely on telehealth access to see specialists in another state, "made possible by licensure flexibilities enacted at the start of the pandemic, so as not to risk exposure to the virus and to maintain continuity of care through virtual options."
"These patients are now faced with canceling these vital appointments or risking an in-person visit and thus exposure to COVID-19," the letter said.
Krista Drobac, executive director of the Alliance for Connected Care, said government and stakeholdders "must build on the lessons learned from the pandemic and ensure patients can access care from their providers regardless of where they live, especially as the pandemic continues."
"Patients and their families seek care across state lines for many reasons," she said, "and the licensure flexibilities put in place throughout the pandemic have been critical for expanding patient access to care, improving care coordination and continuity of care, and addressing workforce shortages. State governors must act to ensure these flexibilities continue and consider solutions to address the ongoing needs of patients both during the pandemic and in the future."
In October, telehealth stakeholders asked the Biden Administration to provide guidance on the anticipated end of the PHE while also calling for the extension of the PHE and its telehealth provisions through the end of 2022.
In a letter to Health and Human Services Secretary Xavier Becerra, American Telemedicine Association CEO Ann Mond Johnson said the PHE created "flexibilities that have allowed clinicians across the country to provide all Americans high-quality virtual care at a time of great need."
“State governors must act to ensure these flexibilities continue and consider solutions to address the ongoing needs of patients both during the pandemic and in the future.”
Krista Drobac, executive director, Alliance for Connected Care
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
Over the last few months, many states have allowed COVID-19 emergency declarations to expire and the licensure flexibilities to expire with it.
Among the flexibilities in the March 2020 1135 waiver put forward by CMS, states were allowed to waive licensing requirements so that remote providers could offer patient care across state lines.
Eligible payments for telehealth services were expanded to include hospital, physician office, and patient home visits, and a range of providers were allowed to bill for telehealth, including NPs, psychologists, and social workers.
Providers were also given the flexibility to reduce or waive cost-sharing for telehealth visits paid for by federal healthcare programs.