Tech & Innovation in Healthcare

Tip: Peruse medical board updates often to keep compliant.

This can be a real problem for healthcare providers that operate businesses across state lines, warned attorney Kyle Y. Faget with Foley and Lardner LLP in the “Regulatory and Compliance Issues in Telehealth” session at the Collaborative Compliance Conference, presented by AAPC and the American Health Law Association (AHLA).

Reminder: When the Department of Health and Human Services (HHS) Secretary determines there’s a high risk of disease and disorder due to an emergency or disaster, a public health emergency (PHE) is declared. Under the PHE, the feds can offer grants, conduct investigations, support state and local healthcare efforts, and waive or modify certain federal requirements to accommodate and/or address the emergency.

Now: HHS Secretary Xavier Becerra renewed the PHE for another 90 days, effective April 21, 2021. This is the fifth time that HHS has extended the PHE; former HHS Secretary Alex Azar originally declared the PHE on Jan. 31, 2020 and renewed it on April 21, 2020, July 23, 2020, Oct. 2, 2020, and, most recently, Jan. 7, 2021, notes PHE guidance.

Check Your State’s Licensure Rules

Under this latest PHE extension, HHS and its partner agencies can continue to offer the popular federal telehealth waivers and flexibilities to providers. From coding and billing changes to HIPAA modifications, there’s a lot covered in the waivers — but that doesn’t mean the state laws must follow the same requirements.

“A provider (physician, NP, PA, etc.) offering care via telehealth is subject to licensure rules of the state in which the patient is physically located at the time of the consult,” Faget said.

Another factor to consider is that individual states determine the telehealth standards and application requirements for providers practicing in their states. “Every state has taken a different approach,” Faget added. “Some are required to register. Some are a free-for-all while other states have a much more conservative approach and want to know who is providing services in their states.”

Good news: During the pandemic, some governors have relaxed licensure requirements, allowing physicians to help patients in a state they aren’t licensed in to thwart the spread of the virus, Faget indicated.

Caveat: Many of the state definitions for telehealth services don’t align with other states’ explanations. In addition, documentation requirements differ by state with some mandating more stringent notes and medical recordkeeping than the feds. Plus, many of the state legislatures continue to tweak regulations and introduce state bills and amendments to their telehealth laws.

Plan for Post-COVID Telehealth Changes Now

Right now, payments are relatively uniform with certain evaluation and management services visits being reimbursed for the same amount whether they’re performed virtually or in person; however, that may not always be the case. In fact, “some states are already seeing some debates by lawmakers that will eliminate payment parity,” Faget acknowledged.