Amy Lerman, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in mHealthIntelligence, Patient Care, Policy & More: A Look at This Year’s Virtual Care Trends,” by Anuja Vaidya.

 Following is an excerpt:

In many ways, 2023 was a year of reckoning for virtual care. From sky-high funding and clinical promises verging on hyperbole to bankruptcy filings and an ongoing patient preference for in-person care, virtual care stakeholders had to concede to some hard truths. Still, the appetite for virtual care is alive and well, making it the stakeholders’ responsibility to assess and optimize the adoption and use of virtual care in the year ahead.  …

Policy and Reimbursement Trends

The virtual care policy landscape has remained relatively steady at the federal level as policymakers extended most of the significant temporary pandemic-era waivers through the end of 2024. …

Amy Lerman, a member of the law firm Epstein Becker Green, echoed this sentiment, stating, “While regulators at both the federal and state levels have remained committed to supporting the use of virtual care services, a related assumption among regulators has been that these services will be provided safely and effectively while acknowledging that healthcare professionals need and want a clear regulatory framework within which to operate.”

While Congress appears to be working toward developing policies that provide such a framework at the federal level, laws governing telehealth are more piecemeal at the state level.

“A continuing trend among states is that no two have been exactly alike in the approach to defining and regulating the practice of virtual care; rather, individual states continue to take their own unique approaches to creating and refining the legal and regulatory framework through which providers of virtual care services are expected to operate,” Lerman said in an interview with mHealthIntelligence.

Some states are more focused on the question of audio-only telehealth modalities and whether provider-patient relationships can meet professional standards of care if they are established solely via these modalities, while others are more focused on ensuring prescriptions are issued only as part of valid provider-patient relationships.

Other areas of focus in 2024 include the use of virtual care by non-physician licensed professionals, Lerman said. States are working to clarify scopes of practice for midlevel and advanced practice providers, as well as requirements around physician supervision of these professionals.

States are also looking into creating remote prescribing policies that are specific to certain types of treatment, such as substance use disorder, and assessing licensure regulations. Though the pandemic eased the cross-state licensure process by encouraging the adoption and use of interstate compacts and special use licenses, there is still more work to be done to ensure widespread access to out-of-state telehealth, and it “will continue to be a challenge in 2024,” Lerman said. …

Regulatory Enforcement Trends

As lawmakers work to resolve the question of pandemic-era telehealth flexibilities, concerns around fraud, waste, and abuse remain. However, these may be largely unfounded. …

Still, even a few cases of fraud, waste, and abuse are a cause for concern among federal agencies. Lerman believes that “telefraud” will remain an area of focus for the HHS’ Office of Inspector General (OIG).

“As of November 2023, current open items in the OIG Work Plan include ongoing work on audits related to use of telehealth for the provision of opioid use disorder treatment services and the provision of home health services, as well as examination of claims and other data related to the general use of telehealth services by Medicare Part B beneficiaries and telehealth-related expansion efforts by state Medicaid programs during the public health emergency,” she said.

Thus, virtual care providers must remain vigilant about ensuring compliance with policies and operational guidelines. Lerman suggested that providers develop comprehensive compliance infrastructures and processes.  

The year ahead promises to be one of change for virtual care stakeholders. With the ongoing integration of virtual care modalities into healthcare — including synchronous, asynchronous, and audio-only telehealth, RPM, digital health tools, virtual reality, and digital therapeutics — these changes will reshape the contours of the US healthcare system.

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