Telehealth as a Tool to Address COVID-19: How Can States Make It Easier to Use?

By Rachel Block

Telehealth can help bolster the front lines of primary care and mental health delivery in these challenging times. As the health care system focuses on the most immediate critical needs of patients with COVID-19, it is likely to be quicker, easier, and safer to access care via telehealth from home than to make an office visit. However, there is only a patchwork of policies in place that determine whether and how telehealth services will be covered by insurance.

Historically payers have covered these services in different ways and so health plans have different policies regarding telehealth coverage and payment. Right now, we need a consistent approach so 1) all consumers benefit from this critical service alternative, and 2) providers get reimbursed just as though they were seeing patients in their offices.

Fortunately, new federal policies are quickly addressing this need. For example:

• Medicare has removed restrictions on telehealth services. Previously, Medicare would only cover telehealth when the person receiving the service was in a designated rural area and/or was receiving the service in a medical facility and not their home.
• States can now apply for Medicaid waivers to expand their telehealth reimbursement and coverage policies.

State policy can make sure that health plans have robust and consistent policies that will make telemedicine successful. And states, as the regulator of health plans, can make a big difference when it comes to the effective implementation of telemedicine. State insurance and Medicaid agencies can provide immediate guidance or requirements to health plans to facilitate telehealth within this framework:

• Telehealth should be a covered service.
• Telehealth copays should be waived (short term) or eliminated (long term).
• Providers should be paid for telehealth services at the same rate as an office visit.
• The telehealth place of service should be expanded to include any facility, office or home and be delivered via phone or video.
• The range of providers who can provide and be paid for telehealth should be expanded.

The state policy landscape is changing very rapidly; Washington State and Rhode Island are two states that have released emergency policies. You can learn more about Washington State’s telehealth efforts in a new Q&A with Sue Birch, RN, director of the Health Care Authority, and Christopher Chen, MD, medical director for the Medicaid program.