Regulatory and legislative issues on telehealth

Area of Science:

• Health Policy
• Telemedicine
• Healthcare Regulation

Background:

• Telehealth adoption was previously limited by federal and state legislative/regulatory barriers.
• The COVID-19 public health emergency (PHE) significantly accelerated telehealth service delivery in the US.
• Temporary waivers during the PHE eased restrictions on telehealth, facilitating its widespread use.

Purpose of the Study:

• To review the legislative and regulatory landscape of telehealth in the United States.
• To analyze changes in telehealth policy during the COVID-19 PHE.
• To provide insights into key issues shaping future telehealth legislation and regulation.

Main Methods:

• Review of legislative and regulatory changes related to telehealth.
• Analysis of policy shifts during the COVID-19 PHE.
• Identification and discussion of ongoing stakeholder debates and issues.

Main Results:

• The COVID-19 PHE led to rapid expansion of telehealth, bypassing previous barriers.
• The permanence of temporary telehealth flexibilities is uncertain, requiring legislative or regulatory action.
• Key debates include audio-only coverage, broadband access, health equity, payment parity, and quality/safety.

Conclusions:

• Future telehealth policy will be shaped by ongoing debates on access, payment, and quality.
• Sustaining telehealth advancements requires advocacy from providers, patients, and policymakers.
• Permanent changes to telehealth policy necessitate action from Congress, state legislatures, and commercial payers.