Amy Lerman Quoted in "Telehealth Laws, Especially for Behavioral Health, Are Increasing Access Despite Remaining Legislative Barriers"

Telehealth laws, they are a-changin’. While states are largely responsible for crafting laws regulating the use and access of telehealth, the legislative picture is gradually becoming more favorable for the remote healthcare model. Adoption, especially in rural markets, is becoming more widespread.

This is particularly true when it comes to the use of telehealth to administer mental health services. A new survey from national law firm Epstein Becker Green has found that both state and federal lawmakers increasingly support coverage for mental health services provided via remote technology, with all 50 states and the District of Columbia now providing some level of coverage for telehealth services for their Medicaid members. …

Amy Lerman, a member of Epstein Becker Green in the Health Care and Life Sciences practice, said laws on the books and under consideration are important due to ongoing shortages of behavioral health providers, even in the bricks-and-mortar context. With a lack of access and resources for patients, telehealth seems a natural fit, owing to the conversational nature of a typical behavioral health session. Conversation-based healthcare encounters are a natural fit for telehealth’s modality.

“Now, in 2019, it’s not perfect, but there’s a lot more informal guidance, a lot more conversation on the websites,” said Lerman. “We’re seeing there are a lot of positive changes.” …

Bills that have been introduced at the state level to support these efforts have been largely bipartisan in nature, said Lerman. Regulations guiding the use of telemental health to date have been administered largely by various state boards of medicine, and those boards have increasingly been addressing things like counseling and psychology. …

Telehealth isn’t completely off the federal radar. HIPAA addresses it to a certain extent, and with respect to the prescribing of controlled substances, there’s the federal Controlled Substances Act. So far there’s not a whole lot more than that, but Lerman anticipates that future DEA regulations could allow for the long-awaited “special telemedicine registration,” which would enable physicians to prescribe controlled substances without conducting a prior in-person examination first. …

“The interstate compact allows anyone who has a principal license in one of the compact states an avenue for seeking out licenses in any of the other compact states,” said Lerman. “But some of the bigger states, the ones you would want to be in there, aren’t a part of it yet. New York, California, Florida, Texas -- in those places it hasn’t been introduced yet.” …

Last autumn, President Trump signed a support act into law that gave a deadline of last Thursday to put new regulations in place, but Thursday came and went and all was still quiet on the remote prescribing front. Lerman expects that if passed, the new regulations could well allow telemental health providers greater freedom and scope in how they’re able to administer care.

A further area of focus, said Lerman, should be in the coverage and reimbursement of telemental health services.

“People pay for it out of pocket, but there’s great interest by consumers of the healthcare system, and payers as well, to cover these types of services,” she said. “The benefits are potentially numerous in terms of providing more access to care, a smoother continuum of care, and promoting proactive rather than reactive care.”