The recently-released Epstein Becker Green (EBG) survey on telemental health laws noted a long-awaited increase in the flexibility of telemental health regulations by state authorities, including telehealth licensure laws. Increased access to telemental health combined with a 25% increase in anxiety and depression globally has led to a surge in funding for behavioral issues in the US. Mental healthcare services across the country have grown to serve the increasing number of citizens covered by expanded policies. The recently enacted Consolidated Appropriations Fund of 2022 approved $1.5 trillion to broaden Medicare telehealth coverage.
Easing Telemental Health Regulations by State Authorities
The EBG report highlights the broadening of telemental health regulations in many states, including the efforts made by some states to make permanent the pandemic-related, temporary flexibilities to ease access acorss state lines and reimbursement. Changes to telehealth licensure regulations by states allowed healthcare many workers to provide services across state lines if they held a license in good standing in their home state and completed a required afidavite in each new state of practice that will soon disappear.
At this point, many states have reduced requirements for remote prescriptions and increased coverage of Medicare or Medicaid for telehealth. While regulations traditionally authorized telehealth prescribers to write scripts for non-controlled substances without an in-person consultation, prescribing controlled substances has met with silence from the Drug Enforcement Agency. Updates have not yet been forthcoming for distance prescribing opioids or other controlled substances such as Adderall.
Telehealth Fraud in 2022
The EBG report also details how federal law enforcement has continued to uncover telehealth fraud over the year. Countrywide, thirty-six people have been charged in 13 states. The fraud-related crimes are valued at $1.2 billion, many related to telehealth fraud. Although most fraud does not involve telebehavioral health providers, the situation has gotten so dire that whistleblowers are now being offered handsome rewards for reporting telehealth fraud.
Telemental Health Laws in 2023
In looking at the future, the EBG report predicts that telehealth providers will need to closely monitor developments in federal as well as state laws and regulations as the industry continues to expand. The report urges a focus on policies and compliance, particularly on coding when billing for telehealth services, as they increasingly will be used to ensure compliant provider behavior. The EBG also encourages a continued focus on prescribing, HIPAA compliance, and patient consent.
As telemental health laws and regulations continue to evolve differently by state, and providers must keep up with changes. In the words of EBG,
Constructing and operationalizing a compliance infrastructure that can manage these changes (e.g., policies and procedures, education, and training) is no longer a “nice to have” but rather a “must have.”
Since 2016, EBG has produced the annual report, “Telemental Health Laws.” The report covers the changes in telehealth licensure laws by state authorities in the preceding year. It presents healthcare providers with recommendations for compliance for many issues, especially for telemental health licensure laws by state in 2023.
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