While HHS has renewed the Public Health Emergency (PHE) through July 19 and is expected to remain in effect through the end of the year, many states are allowing their public health emergency orders to expire.  The expiration of these PHE orders will impact the use of telehealth in all settings, including long-term care.

During the PHE, CMS waivers allowed telehealth services furnished by physicians and other covered practitioners (subject to state laws) to Medicare patients to include telehealth visits between a provider and new or established patients, virtual check-ins via telephone, E-visits through an online patient portal, the elimination of geographic restrictions for patients and providers, and allowing providers to furnish services outside their state of licensure.

On the federal level, there is bipartisan support for several bills relating to telehealth, including the Telehealth Modernization Act, the CONNECT for Health Act of 2021 (Creating Opportunities Now for Necessary and Effective Care Technologies), the Protecting Rural Telehealth Access Act, and the Telemental Healthcare Access Act of 2021.  Legislation is needed in order for the waivers enacted during the COVID-19 pandemic to become permanent on a national level.

Many states have allowed their public health emergency orders to expire, thus ending some flexibility for telehealth.  For example, as of June 26, healthcare providers in Florida can no longer use audio-only telehealth platforms for non-Medicare patients, prescribe controlled substances via telehealth, continue telemental health services at the current level for Medicaid patients, and allow providers from other states to virtually treat Florida residents.  In Alaska, the emergency provision that allowed out-of-state providers to practice telehealth has also expired.

Meanwhile, Idaho and Delaware have made many emergency rules related to telehealth permanent, and Connecticut has extended COVID-19 telehealth coverage for two years.  Clearly, telehealth regulations, particularly for non-Medicare patients, will be varied among the 50 states as the PHE comes to a close.

Excelas will continue to monitor developments related to telehealth and its impact on the delivery of healthcare in the long-term care setting.