Telemedicine Regulations Represented by Stethoscope, Gavel, and Laptop

The Future of Telemedicine Regulations under the Biden Administration

Twelve months ago, few, if any, could have predicted that the public health emergency caused by the COVID-19 pandemic would linger on into a new presidential administration. Dissatisfied by the lackluster pandemic relief bill passed by Congress and signed by President Trump just before Christmas, which failed to extend the pandemic’s eased stance on telemedicine regulations, industry stakeholders are now looking to President-elect Biden and the 117th Congress to sanction more permanent measures in order to preserve the sudden rise in telemedicine usage during the pandemic. Under the current administration, lightened restrictions and legislation have enabled health care providers to steer patients towards telemedicine visits while recouping the costs of running a telemedicine program—but only for the duration of the public health emergency. Now, with President-elect Biden ready to take the reins, telemedicine proponents are urging him to make those altered restrictions permanent in order to encourage the continued use of telemedicine; otherwise, they fear that telemedicine usage may drop to its paltry pre-pandemic levels, which would reverse many of the advancements made in health care delivery during the pandemic.

As explained by former Senate majority leader Dr. William Frist, R-Tennessee, the weighty concerns surrounding telemedicine regulations before the pandemic—especially reimbursement, privacy and security, interstate licensure, and unfamiliarity—were quickly overridden in favor of maintaining the public’s access to health care while limiting the spread of COVID-19—regardless of the cost. Private insurers gamely followed the federal government’s lead by expanding their own telemedicine initiatives and waiving cost-sharing. The temporarily-lifted restrictions on telemedicine permitted explosive growth in virtual care and demonstrated that telemedicine does indeed offer a legitimate and effective method of health care delivery. Over 60% of providers surveyed by the ATA indicated that telemedicine helped to improve their patients’ health and enhanced the timeliness of care, and a recent HIMSS survey revealed that 77% of consumers are willing or prefer to use some form of telemedicine after the pandemic’s resolution.

However, as vaccines roll out, bringing the end of the pandemic emergency within sight, many advocates fear that the eased telemedicine regulations will revert to their pre-pandemic levels—as is likely to occur automatically upon the declared “end” of the public health crisis. Such backtracking would essentially terminate payment parity in reimbursements, limit the playing field to only those who are strictly HIPAA-compliant, and eliminate the new convenience and increased access to care welcomed by both patients and providers during the pandemic.

Thus, says Frist, safeguards need to be put in place to sustain the current, widely accepted position of virtual care. During the past several months, lightened telemedicine regulations and restrictions have allowed patients to access care regardless of their location or their provider’s location, eased cross-state licensing barriers, mandated telemedicine reimbursement in the form of payment parity, and reduced enforcement of compliance with HIPAA standards. In addition, the definition of telemedicine, expanded to include communication methods besides real-time audio-visual interactions, temporarily categorizes audio-only interactions and asynchronous consults as valid telemedicine encounters that are eligible for equal reimbursement as compared to in-office visits. Together, these factors have connected patients and providers to an unprecedented degree and thus, many believe, should be extend beyond the public health emergency.

During the opening day of a recent virtual American Telemedicine Association (ATA) conference, analysts predicted that Biden’s administration will support the continuation of telemedicine usage in the forms of expansion of broadband infrastructure, fair reimbursement rates (although without payment parity necessarily), and inclusion of alternative methods of communication, as described above. Despite the enthusiasm backing these updated telemedicine regulations, some remain concerned that current disparities in patient care in brick-and-mortar health systems could inadvertently carry over to the latest telemedicine deployments, i.e., underserved patients in the traditional system may still face challenges in accessing care even with new telemedicine programs in place.

Overall, the sentiment among members of the ATA is positive and offers an “overall rosy future for telehealth under President-elect Biden’s administration,” as predicted by Dr. Molly Joel Coye, AVIA Executive in Residence.

To learn more about the widespread concerns surrounding the future of telemedicine as a standard component of healthcare, visit Healthcare IT News here.
To read a transcript of Frist’s discourse at the ATA conference, including his proposed policies for telemedicine, visit the ATA here.

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