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The events of this last week have gone a long way toward convincing practitioners that telehealth is legitimate, safe, and reimbursable. Barriers to the adoption of telehealth are crumbling in the face of the coronavirus pandemic.
On March 6, 2020, Arthur Evans, PhD, the CEO of the American Psychological Association released a memo encouraging practitioners to consider telehealth to help with the delivery of services to existing clients and patients. Many other national and state, as well as country professional associations and licensing boards across the country are following suit.
Many of these groups have sent a variety of emails to their memberships, encouraging practitioners to:
- Stay at home
- Start using telehealth tools to reach clients and patients
- Study existing guidelines
- Check their malpractice policies
- Stay current with the quickly changing landscape
We at TBHI are getting regular emails from past Certificants as well as current Learners who are reporting similar actions by their professional associations or boards. Many states have opted to waive restrictions on the use of telehealth during the pandemic.
Federal Legislative Telehealth Policy Changes
On March 6, 2020, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (the HB 6074). The act grants limited powers to the Secretary of Health and Human Services to waive several key Medicare telehealth policy restrictions, allowing it to be used more widely in coronavirus situations. However, HB 6074 only addresses the lifting of some barriers to using Medicare for reimbursement. This change in telehealth policy represents a long-awaited relaxing of Medicare requirements that have been advocated by the telehealth community for decades. While these changes are important in the overall telehealth landscape, it must be remembered that most Americans are not Medicare beneficiaries and current restrictions still exist from other payers.
Last week’s legislative action followed the lowering of telehealth policy barriers related to the treatment of opioids in early October of 2018, when Congress overwhelmingly passed opioid legislation called the SUPPORT for Patients and Communities Act (HR 6). It was passed by a vote of 98-1, while the House approved it 396-14. The 660-page bill was signed into law on October 24, 2018. It included more than $3.3 billion in authorized spending over 10 years. The Act included provisions to improve Medicare reimbursement for telehealth programs and support an innovative technology-based program that trains rural and remote healthcare providers in the treatment of patients with substance abuse and other behavioral disorders.
These events and many more than preceding COVID-19 are converging to create a tipping point for telehealth policy. Perhaps the gravitas of these events can best be captured by quoting the AMA, who prior to COVID-19 making its pandemic mark, we cited in our Telebehavioral Health Newsletter on February 17, 2020:
The American Medical Association says nearly 75 percent of all doctor, urgent care and emergency room visits could be handled safely and effectively over the phone or through a video.
If the AMA is right about medical care and telehealth, there’s no reason for those of us in behavioral care to wait.
How TBHI Is Helping
The Telebehavioral Health Institute is honored to be able to offer three special programs and discounts to help practitioners and program directors seeking to develop immediate telehealth programming. In response to many requests, we are developing special packaging for our group programs (keep your eye out for another blog post about that soon) but meanwhile, we have made a few decisions that we hope that you will support:
50% Site-wide Telehealth Training Discount
Starting immediately, TBHI is offering an emergency response discount of 50% sitewide to any individuals or groups seeking any form of training in the next 30 days.
Prices for both Micro Certifications are already adjusted to reflect 50% off. When purchasing individual courses, use this code:
2. FREE Learn to Practice Telehealth from Home Webinar
TBHI has re-designed one if its most popular and relevant webinar recordings so as to share it with you. TBHI offers this free training to anyone who registers. Learn the ins and outs of legal and ethical issues related to working from home. This information will awaken you to the range of challenges that can arise, and describe how you can prevent them. It will explain relevant laws and ethical codes. See this page for a full description, attend, and sleep at night.
How You Can Help
News of legislative telehealth policy change is coming to TBHI from many states. If you have news from your state, post it below so that others can see what’s happening. Includes links to source documents and articles if you can. Also, please tell others about your experience at TBHI. Let your colleagues on listservs, social media, and other areas know about the resources that we offer and how we might help them develop their telehealth services. For those of you who have already written to lend a hand, we thank you. Let’s continue to work together to keep everyone safe.
Marlene M. Maheu, PhD has been a technologist-psychologist and pioneer since 1994. She has served various organizations to assist with the development of technology-focused standards and guidelines, including the American Telemedicine Association, the American Psychological Association and the American Counseling Association. She has overseen the development and delivery of telehealth training to more than 41,000 professionals worldwide and consulted with hundreds of hospitals, clinics, agencies, groups and independent practitioners seeking start-up guidance.
Dr. Maheu serves as the Founder & Executive Director of the Telebehavioral Health Institute, which offers over 64 hours of both basic and advanced telehealth training online and offering two Micro Certifications Telehealth. She is the CEO for the non-profit Coalition for Technology in Behavioral Science (CTiBS). She has authored five telehealth textbooks, including the Telebehavioral Health: Foundations in Theory & Practice for Graduate Learners (2020); the APA-published, A Practitioner’s Guide to Telemental Health: How to Conduct Legal, Ethical and Evidence-Based Telepractice (2016), and Career Paths in Telemental Health (2016).
Introduction to Telehealth Theory & Practice
Enjoy a fast-moving overview of telebehavioral and telemental health. Understand the key points related to telehealth clinical, legal, ethical, technology, reimbursement, social media and other pivotal issues.
With the “relaxed” Medicare changes due to the COVID-19 virus in the HB6074 legislation, are providers able to bill Medicare for psychotherapy services? I practice in Arizona….
Thank you in advance for all the information you provide to the profession….
Patricia Watson, Ph.D.
Patricia, We have been billing Medicare for telehealth for almost two decades. They had many restrictions but those have now been removed. It looks like some of those restrictions will not be reinstated moving forward. Please see some of our more recent blog posts and our newsletter for free details: https://blog.telehealth.org/signup
Of course, an epidemic would push forward the technology that was seen as progressive. I will look on the CMS site for more Information regarding Medicare and its reimbursement related to Telehealth.
I took the online course with Dr. Maheu over a decade ago, paid for it, though then moved to New Zealand until 2017. The course covered the technology, safety (the “Blue Car” for when someone else is in the room) and grounding — getting emergency numbers, resources, etc. Its orientation was toward new patients.
Now we’re looking at moving established patients from live to online: I imagine there would be a sense of loss involved; also, a need to somewhat reformulate boundaries. Also, what was then “borderline personality disorder” is now “complex PTSD” — the relationship being even more of a treatment element (perhaps I exaggerate, or project my own practice). My office is full of pictures, statues, etc. — wondering how we manifest our presence and emotional availability using electronic means. Or evden who may be considering this. Thanks.
Sorry for the delayed response. We have been inundated for the last several months. For the more advanced issues that you bring up, I encourage you to take a fun, 4-hour advanced clinical issues course that we now offer monthly on a Saturday. The next one will be Saturday, August 15. See the details here. We’ve had hundreds of professionals attend previous live, interactive sessions to date and it is a very-informative, clinical crowd-pleaser. It also comes with a 4-Hours of CME or CE credit.
I can’t find a link to the “FREE Learn to Practice Telehealth from Home Webinar.”
How does one access this webinar?
Cherie Gustafson, MA, LCPC
Cherie, Thank you for your question. This is the link to the free course: https://blog.telehealth.org/covid
In New Jersey, at a conference call with the Department of Health, providers were told that they must continue to follow the State requirements of having clients/patients come into the office in order to participate in telehealth which encourages the opposite of the social distancing necessary for prevention. These are people with mental illness who need the ongoing support of counseling to accompany their pharmacological treatments.