Telehealth
In response to the COVID-19 public health emergency, states have taken measures to alleviate the occupational licensure policy burdens that impede state response efforts and which are counterintuitive to social distancing practices. The following information presents a collection of policy actions states have implemented to expand telehealth services.
The enhanced use of telehealth/telemedicine services allows states to augment the availability of health care services while promoting social distancing. Several states have taken actions that reduce regulations associated with telehealth, including allowing practitioners (including those out of state) not normally authorized to deliver telehealth services to do so and modifying in-person examination requirements which are a pre-requisite for telehealth services.
Click to view each state’s actions
Colorado
- EO 2020-020 – Suspends the statutory definition of “telehealth” to broaden the range of acceptable technologies and services, mandates insurer coverage of telehealth, suspends limitations on out-of-state mental health professionals’ ability to practice in Colorado; allows veterinary telemedicine without an existing vet-client relationship.
- EO 2020 046 (Extends EO 2020 020) – Temporaily suspends certain statutes relating to telehealth to increase its use.
- EO 2020 082 and 2020 116 – Extend Executive Orders 2020 020 and 2020 046 Concerning the Temporary Suspension of Certain Statutes to Expand the Use of Telehealth Services Due to the Presence of COVID-19.
Connecticut
- Executive Order 7DD – Expands the range of professions allowed to provide telehealth services to include dentists, behavior analysts, genetic counselors, music therapists, art therapists, and veterinarians; allows for telehealth services via audio-only telephone; suspends certification requirements for telehealth providers; loosens privacy and record-keeping requirements for telehealth; and mandates that un- or under-insured telehealth patients be billed at the Medicaid rate, with financial assistance available.
- Executive Order 7FF – Allows Medicaid-enrolled providers to provide telehealth services to new or established Medicaid patients through audio-only telephone.
- Executive Order 7DD – Expands the range of professions allowed to provide telehealth services to include dentists, behavior analysts, genetic counselors, music therapists, art therapists, and veterinarians; allows for telehealth services via audio-only telephone; suspends certification requirements for telehealth providers; loosens privacy and record-keeping requirements for telehealth; and mandates that un- or under-insured telehealth patients be billed at the Medicaid rate, with financial assistance available.
Delaware
- Second Modification of the Declaration of Emergency Due to a Public Health Threat – Allows out-of-state medical providers to practice in Delaware via telehealth if their profession is telehealth-eligible within the state. Suspends the Delaware medical board’s Regulation 19 governing the use of telehealth.
- Eighth Modification of the Declaration of Emergency Due to a Public Health Threat – Suspends any remaining restrictions on telehealth so that no in-person contact between provider and patient is required before or during telehealth service.
Georgia
- EO 03.20.20.02 – Directs Georgia Composite Medical Board to immediately adopt emergency rules to provide telehealth licenses.
EOs 04.08.20.02, 04.30.20.1, 05.28.20.01, and 06.29.20.01 – Extend the Public Health State of Emergency declared by Executive Order 03.14.20.01 that provides for telemedicine licenses.
Idaho
- Proclamation (April 2) – Suspends requirement for an existing patient-provider relationship to practice telehealth, allows prescription of controlled substances via telehealth.
- Proclamation (April 23) – Suspends statutory definitions related to telehealth and suspends disciplinary provisions associated with improper use of telehealth.
- Proclamation (April 2) – Suspends requirement for an existing patient-provider relationship to practice telehealth, allows prescription of controlled substances via telehealth.
Iowa
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- Proclamation of Disaster Emergency – Authorizes out-of-state mental health professionals to use telehealth to reach Iowa patients.
- Proclamation of Disaster Emergency (April 2) – allows for remote mental health services by out-of-state mental health professionals and modifies the definition of telehealth to include audio-only telephone transmission.
- Proclamation of Disaster Emergency (April 24) – Allows for licensed out-of-state telehealth providers to be licensed in Iowa.
- Proclamations of Disaster Emergency (May 26, June 25, and July 24) – Extend 3/22 and 4/2 proclamations including the allowance of remote mental health services by out-of-state mental health professionals.
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Kentucky
Louisiana
- Proclamations JBE 2020-52, JBE 2020-59, JBE 2020-75, JBE 2020-84, JBE 2020-97, and JBE 2020-102 – Extend all prior proclamations, including those expanding access to telemedicine and the way it may be delivered, and extends state of emergency.
Maine
- Executive Order 16 – Authorizes use of telehealth by in-state and out-of-state physicians, physician assistants and registered nurses via any telecommunication technology; suspends any patient confidentiality requirements that may conflict with telehealth delivery.
- Executive Order 35 – Authorizes use of telehealth by all other in-state and out-of-state medical professionals, including veterinary, via any telecommunication technology suspends any patient confidentiality requirements that may conflict with telehealth delivery.
- Executive Order 16 – Authorizes use of telehealth by in-state and out-of-state physicians, physician assistants and registered nurses via any telecommunication technology; suspends any patient confidentiality requirements that may conflict with telehealth delivery.
Montana
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- Directive Implementing Executive Orders 2-2020 and 3-2020 and providing for expanded telehealth – Authorizes use of all modes of telehealth, including audio-only, and waives strict compliance with the respective telehealth requirements of the boards of medical examiners, psychologists, and speech-language pathologists.
- Directive (April 21) – Implements Executive Orders 2 and 3 and allows healthcare professionals to utilize telehealth.
- Directive (April 21) – Further expands previous telehealth directive on 3/20. Suspends rules limiting telehealth usage and requiring face-to-face interactions. Requires insurance coverage parity between telehealth and in-person services.
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Pennsylvania
- Department of State Telemedicine Guidance (March 18) – Authorizes telehealth practice by all professions regulated by the state’s medical, behavioral health, physical therapy, and veterinary licensing boards, including by out-of-state practitioners.
- Department of State Waiver (March 26) – Allows for clinical social workers, marriage and family therapists, professional counselors, and psychologists who are receiving supervision for clinical experience to provide teletherapy services if their supervisor complies with all required regulations.
South Dakota
- Executive Order 2020-07 – Suspends statutes and regulations limiting provision of telemedicine and requiring face-to-face visits.
- Executive Order 2020-16 – Suspends statutes requiring a prior patient-provider relationship, limiting virtual prescription of certain medication, and requiring real-time visual communication technology or prohibiting audio-only telehealth service.
- Executive Order 2020-07 – Suspends statutes and regulations limiting provision of telemedicine and requiring face-to-face visits.
Tennessee
- EO 24 – Authorizes the Commissioner of Health to allow persons who have completed postgraduate training in behavioral or mental health to provide services in Tennessee without a license, including through the use of telehealth technology.
- EO 36 – Allows all licensed in-state and out-of-state healthcare providers to practice in Tennessee via telehealth; urges insurers to remove any restrictions on telehealth services.
Texas
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- Governor’s Directive (March 14) – Directs the Texas Medical Board and Board of Nursing to allow telehealth practice by licensed in-state and out-of-state providers.
- Medical Board Guidance (March 14) – Allows patient-provider relationship to be established via telehealth, including audio-only.
- Department of Insurance Emergency Rule (March 17) – Requires telehealth visits for patients with state-regulated plans to be billed the same as in-office visits for insurance purposes.
- Press Release (March 20) – Allows pharmacists to conduct telephonic consultations.
- Press Release (April 7) – Allows pharmacy technicians to accept prescription orders over the phone and to send or receive a transfer of original prescription information on behalf of patients.
- Press Release (April 9) – Waives certain telehealth restrictions to allow for use of a smart phone or any audio-visual, real-time, or two-way interactive communication system in remote practice by speech pathologists, audiologists, behavior analysts, hearing aid fitters, and dyslexia therapists.
- Medical Board Emergency Rule §174.5 (June 19) – Modifies telehealth rules for chronic pain treatment to allow physicians to renew prescriptions of scheduled pain medications via telehealth (but not to issue new prescriptions).
- Texas Board of Nursing Emergency Rule §217.24 (July 7) – Modifies telehealth rules for chronic pain treatment to allow advanced practice RNs to renew prescriptions of scheduled pain medications via telehealth (but not to issue new prescriptions).
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Washington
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- Senate Bill 5385 (March 19) – Requires insurers to reimburse telehealth services at the same rate as if the services were provided in person (payment parity).
- Proclamation 20-29 – Provides for provisions of Senate Bill 5385 (payment parity for telehealth) to take effect immediately rather than on Jan. 1, 2021.
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West Virginia
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- EO 10-20 – Allows telehealth practice by licensed in-state and out-of-state practitioners and permits use of non-video technologies.
- EO 17-20 – Suspends statutory provisions requiring in-person examinations to refill a schedule II opioid prescription.
- EO 31-20 – Suspends requirement that a speech-language pathologist or audiologist must be licensed by the State Board for Speech-Language Pathology and Audiology in order to telepractice and allows ASLPs licensed by the Department of Education to telepractice.
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