Deregulation Lets Telehealth Thrive

By: Laurel Duggan

At least twenty-three states are temporarily easing regulations on telemedicine in response to COVID-19. There are now more than 500 repealed regulations – including regulations that put up barriers to telehealth and healthcare. The regulations in question prevent healthcare providers from working across state lines; require an in-person relationship with a provider in order to begin digital care; and restrict the types of technology that can be used by patients to access telehealth services. Many of these regulations are not necessary to begin with, and should be permanently lifted to expand healthcare access, improve quality, and drive down costs.

New Jersey, Maryland, and Texas have expanded the types of devices and technologies eligible for telemedicine services. Smartphones, tablets, and asynchronous technologies, such as email, were previously prohibited. Similar reforms are happening at the federal level; the Health and Human Services Department has waived restrictions against telemedicine via Facetime, an activity which would usually run afoul of HIPAA rules.

Other telehealth reforms at the federal level will expand Medicare services to be offered through telemedicine, allow healthcare professionals to work across state lines, and allow medical providers to bill telehealth services at the same rate as in-person visits. Additionally, the FCC has lent 51.9 GHz spectrum to wireless service providers to help rural communities access vital online services including telehealth.

The slashing of red tape at the federal level has only just begun. The president issued an executive order this week to revitalize the economy through deregulation. Federal agencies are instructed to identify regulations that can be waived and not to over-enforce regulations when a business is operating in good faith.

States including Iowa, Arizona, California, Colorado, Hawaii, Louisiana, New Hampshire, New Jersey, New York, South Dakota, and Utah, have made broad reforms to deregulate and expand telemedicine.

Arkansas, Delaware, Missouri, and South Dakota have waived requirements that patients have an in-person relationship with a provider before receiving telemedicine services. Such rules restrict access to innovative direct-to-consumer services that bypass the traditional medical system. Online eye exams, for example, have existed for four years and are a trusted, cost-effective, and convenient way to deliver an essential health service. These services are typically offered by large national companies rather than local doctors, so providers are unlikely to be licensed in a patient’s home state. Rural Americans, many of whom are long drives away from optometrists, now have unprecedented access to quality eye care. But regulations built for a pre-internet world make such services inaccessible in states with prior-relationship laws still on the books. 

Connecticut, Maine, Alabama, Florida, Minnesota, Missouri, New Hampshire, New York, and Idaho have eased laws prohibiting out-of-state healthcare workers. This will improve access to telemedicine during the pandemic, but will also expand healthcare access in general, particularly for those living near state borders. Many states still restrict out-of-state medical workers, which has slowed the growth of telemedicine and limited access to healthcare more generally.

Deregulation has allowed medical professionals to respond quickly and effectively to COVID-19, but it has also proven that many cumbersome and costly healthcare regulations were never necessary to begin with. Legislators must recognize the cost-saving and life-saving benefits of telehealth and make deregulation permanent.

Photo by NEC Corporation of America with Creative Commons license.