Stakeholders’ recognition of telehealth benefits has continually increased, as doors are now opening for various subsets of medicine, including tele-mental health, according to new research from law firm Epstein Becker Green (EBG).
The 2018 Tele-mental Health Laws survey provides an update to state telehealth laws, regulations, and policies for mental and behavioral health practitioners and stakeholders across all 50 states and the District of Columbia. The survey’s researchers said that in the last few years, “the public’s and the healthcare industry’s recognition of the benefits of telehealth has continually increased. While the shortage of behavioral health providers has long been acknowledged, the use of telehealth technologies, including practice management systems and online patient portals, to provide greater access to behavioral health professionals has increasingly gained traction and continues to gain validation as an alternative model of care delivery.”
What’s more, EBG also found that current events and issues, such as the opioid epidemic, have put more pressure than ever before on federal and state legislators to pass laws that promote access to, and provide guidance for, providers seeking to utilize telehealth services.
The survey revealed various reasons for the increase of access to tele-mental health services, and telehealth services overall, including:
Bipartisan support: The Bipartisan Budget Act of 2018 signed into law in February expanded Medicare coverage for certain telehealth services to beneficiaries who are being treated by practitioners participating in accountable care organizations (ACOs).
Greater advocacy from Medicare & Medicaid: In June 2018, the Centers for Medicare & Medicaid Services (CMS) publicly encouraged states to utilize telemedicine and telepsychiatry to facilitate coordinated care for Medicaid recipients. As of August 2018, 49 states and the District of Columbia provide reimbursement for live video telehealth services through Medicaid fee-for-service programs. Massachusetts is the only state not yet participating.
The opioid epidemic: Several states, including Indiana, Michigan, and Missouri, have introduced and/or passed legislation that expands remote prescribing of controlled substances for treatment of substance use disorders (SUDs). In October 2018, President Trump signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (“SUPPORT”) for Patients and Communities Act.
This year’s survey also looked at positive trends in telehealth adoption and usage models, including: school sites and pediatric care; the Department of Veterans Affairs’ expanded telehealth programs (since its rollout, the VA’s telehealth program has onboarded approximately 20,000 new patients and hosts more than 6,000 virtual visits each week); and the promotion of care models for growing aging-in-place populations.
Despite the continued telehealth momentum, several barriers and policy variances do remain, the researchers stated. Some of these include: limited federal guidance on coverage and reimbursement and the lack of meaningful coverage by third-party payors, the report said. To this end, A recent MedPAC survey noted that coverage of telehealth services continues to vary widely across commercial health plans, with most covering only one or two types of telehealth-based services.
“While telehealth parity laws are currently in effect in 39 states and the District of Columbia and are intended to ensure the same coverage of (and in some cases, reimbursement for) telehealth services, there is more work ahead to achieve comprehensive coverage and access. States must continue to enact new parity laws or expand existing ones,” the researchers stated.