Some patients forgo care as states cut telehealth provisions: 8 details 

Jackie Drees -

Half of U.S. states have stopped emergency declarations that waived licensing requirements for out-of-state clinicians conducting telehealth visits, leaving patients across the country unable to access care or scrambling for new providers, The Wall Street Journal reported Nov. 22.

Eight details: 

1. During the pandemic, all 50 states and Washington, D.C., used emergency declarations to lift some parts of licensing requirements for out-of-state physicians providing telehealth visits, according to the Alliance for Connected Care. Since then, 25 states have stopped the provisions, the Journal reported. 

2. The provisions have helped patients who are poor, elderly or live in remote areas access care via audio-only telehealth, as many of these people lack access to phones with video or camera functions, NPR reported Nov. 23. 

3. About half of U.S. states have enacted measures to keep audio-only telehealth in place, but the remaining states lack such legislation and are bound by older restrictions for telehealth that have gone back into place or are set to return when the public health emergency ends sometime after the end of 2021, according to NPR

4. Insurers are also divided on telehealth coverage policies. Medicare said it will cover audio-only telehealth visits for mental and behavioral health visits through 2023, but some private payers have stopped reimbursing coverage for audio-only care. 

5. Jennifer Roman, a 27-year-old with rare neurological condition idiopathic intracranial hypertension, as well as inflammatory disorder Behcet's disease, told the Journal that, in June, her insurer said it would stop covering out-of-state telehealth visits. 

6. Ms. Roman was told she would have to drive two hours to visit each of her physicians at Johns Hopkins University and New York University since her state doesn't have appropriate specialists for her rare conditions. Without access to virtual care, she said she has been forgoing appointments that were conducted virtually last year. 

"For people in the rare-disease community, what's happened as a result of telehealth coverage being cut back is, we have been left behind to get worse," she told the Journal

7. Some hospitals, physicians and telehealth providers have advocated to make pandemic provisions for telehealth permanent to expand access to care and treatment. 

8. Some licensing boards have opposed extending telehealth services. Lisa Robin, chief advocacy officer at the Federation of State Medical Boards, told the publication that an expansion of telehealth could lead to more fraud in the industry; in September, the Justice Department charged 138 providers in connection with a combined $1.4 billion fraud involving telemedicine.


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