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Government loosens licensing restrictions for clinicians during COVID-19 outbreak

Legislative Updates for Coronavirus

Last updated: April 23, 2020 at 11:00 a.m. EDT

Government loosens licensing restrictions for clinicians during COVID-19 outbreak

Congress has been working on various emergency healthcare measures, including the Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074), which would temporarily loosen restrictions for practicing across state lines and increase access to telemedicine. The Department of Health and Human Services (HHS) secretary has the authority to waive the originating site requirement in any emergency area identified by the Centers for Medicare and Medicaid Services (CMS) during an emergency timeframe. This means clinicians will be able to bill Medicare and Medicaid for telehealth services delivered to patients during the current pandemic. Please note this situation is evolving each day, so to see real-time updates, visit: hhs.gov and cms.gov.

For specific telehealth legislative updates, please visit The Center for Connected Health Policy (CCHPCA). This page offers informational resources regarding policy changes for telehealth services with Medicare, Medicaid and private insurers during the pandemic and you can see state actions here

Clinicians now able to practice across many state lines

Vice President Pence stated: "HHS is issuing a regulation today that will allow all doctors and medical professionals to practice across state lines, to meet the needs of hospitals that may arise in adjoining areas," Pence said. This is currently in the works, but the Federation of State Medical Boards (FSMB) has a list of states currently allowing physicians to work in their states with other state licenses or an emergency temporary license. This list changes daily, so please keep checking back. 

Nursing boards are also issuing emergency/expedited licenses. The National Council of State Boards of Nursing (NCSBN) has an updated list of states temporarily loosening nursing license restrictions.

Disclaimer: In many of these states, the expansions apply only for clinicians treating COVID-19 patients. Please check with your state medical board or the fsmb.org website for specific details about allowed services.

HIPAA law is loosened for video chat

HHS is now allowing physicians to converse with patients across various video avenues, without penalty of violating The Health Insurance Portability and Accountability Act (HIPAA) laws. Acceptable forms of video communication now include Skype, Facebook Messenger, Google Hangout and Apple FaceTime. To see the full list of approved video chat formats, visit HHS.gov.

Blanket waivers updated

To review the blanket waivers CMS has authorized for various healthcare environments (updated 3/13/20), see its recent document “COVID-19 Emergency Declaration Health Care Providers Fact Sheet.”

DEA updates prescribing authority

The Drug Enforcement Administration (DEA) has also made temporary changes to the Ryan Haight Act that loosen restrictions on prescribing controlled substances via telemedicine so long as the clinician is acting in accordance with federal and state law, the drug is prescribed for a legitimate medical purpose and the telemedicine session is conducted with an audio-visual, real-time, two-way interactive communication system. For more details, visit the DEA’s website.

Private payers also make adapting to telehealth easier for patients and providers

Many private insurers are also loosening restrictions for telehealth regulations. For example, Aetna is temporarily eliminating its co-pay on telemedicine visits so all commercial health plan patients can be diagnosed without exposing themselves in public. Blue Cross Blue Shield is waiving prior authorizations for diagnostic tests and covered services through telemedicine.

Please visit each insurer’s website to get up-to-the-date information as details are changing hourly.