Tele-Health is changing rapidly; here is how you can keep up
Since the start of the epidemic turned pandemic of COVID-19 we have seen rapid changes in laws, rules, and regulations. Things can change from hour to hour, and this leaves many clinicians with questions and confusion.
The coronavirus pandemic demands that health care providers rethink how they deliver care in ways that reduce risk of further spreading infection. Telehealth is one approach that can help keep both patients and providers safe, but clinicians need to understand the current regulatory and payer telehealth landscape
Have a question about what you can and can’t do amid all the regulatory and payment changes happening in response to the COVID-19 pandemic? The answer will probably be the same no matter what: Check with your state physical therapy licensing board and each of your payers.
The American Physical Therapy Association states “It can’t be stressed enough: Individual states are the decision-makers around much of what PTs and PTAs can and can’t do in response to the COVID-19 pandemic. These regularly updated resources can help you make fact-based practice decisions.”
“While there have been changes at the federal and commercial insurer levels around, for example, the kinds of digital communications PTs can have with patients, state laws often take precedence,” said Daniel Markels, APTA state affairs manager. “If your state laws and regulations don’t allow you to do it, even if the insurer you’re working with says they’ll pay for it, you can’t do it. On the other hand, states have made temporary changes to various laws that may provide additional opportunities for PTs and PTAs, so it’s crucial to keep up with what’s happening at the state level.”
In the United States the regulation of professions is a power invested with the states, not the federal government, meaning that each state has the authority to regulate and license providers. While this has advantages, it can make telehealth confusing for providers and patients. This is especially true for those who practice close to a state line.
The APTA recommends four key resources to help you stay on top of changes and regulations:
“Can I provide telehealth?” is the question most asked by nearly every PT and PTA these days. This chart, which is updated weekly, breaks down the answer to that question by state, with links to specific orders. Always check your state practice act and with your state licensing board to verify what you are and aren’t allowed to do.
States have been changing their Medicaid and commercial insurance regulations in a variety of ways when it comes to telehealth, including some mandates that nonfederal payers must pay for telehealth services as if the services were performed in person. Other states don’t mention physical therapy services specifically. It is recommended that you check with your state licensing board or specific insurance companies for the most accurate and current information. The APTA updates this chart weekly: http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Patient_Care/Technology/Telehealth/Coding_and_Billing/TelehealthCOVID19StateMandatedHealthOrders.pdf
This chart, created by the Federation of State Boards of Physical Therapy, provides a detailed listing of every change made to licensing laws and regs in response to the health emergency. It focuses on exemptions and changes to licensure requirements, including issuance of temporary licenses without an examination to allowances for PTs licensed in another state. It also notes states that temporarily allow a PT or PTA licensed in another state to come in and practice without having to obtain a license from the state during declared national or state emergencies.
This is a regularly updated listing of every licensing board, including email addresses, websites, and phone numbers, from the Federation of States Boards of Physical Therapy.
For anyone entering the world of telehealth, or for those who have done it on a cash basis and are expanding into billing insurances at this fast changing time it is recommended to check back often at the above resources to stay on top of changes.