Three telehealth services on the rise


An Epstein Becker Green survey has surprising results about the expansion of telehealth services physicians and other behavioral health professionals can provide.

Telemental, telebehavioral and telepsychiatry services are increasingly used by practitioners and healthcare systems, according to a new survey.

According to HHS, it is estimated that 61% of healthcare institutions use some form of telehealth, and between 40% and 50% of all hospitals in the U.S. currently employee some form of telehealth.

Epstein Becker Green (EBG) released an Appendix to its 50-State Survey of Telemental/Telebehavioral Health (2016), with new and updated analysis on the laws, regulations and regulatory policies affecting the practice of telemental/telebehavioral health in all 50 states and D.C.


“As consumers continue to seek access to telebehavioral health services, the prevalence of these services has given rise to a number of significant legal and regulatory issues, including privacy and security, follow-up care, emergency care, treatment of minors, remote prescribing, and reimbursement,” says Amy Lerman, a member of the firm in the Health Care and Life Sciences practice, in the Washington, DC, office of EBG. “While some federal laws and regulations-e.g., HIPAA-apply, most of these issues involve an examination of individual state laws, which for providers of these services has resulted in an inconsistent patchwork of statutes, regulations, and other state-specific guidance, all of which can vary widely by state, if the state even addresses provision of telebehavioral health services at all.”

The basic findings of the Appendix include the fact that while regulations for physicians (e.g., psychiatrists) are still the most prevalent, states also have started to expand their regulatory frameworks with respect to other types of behavioral health providers, including psychologists, social workers, and counselors.

“Interestingly, and only apparent in New Jersey-so far-the enactment of a new telemedicine law includes a fairly broad definition of the term ‘healthcare provider’ and this suggests a movement toward greater acceptance of different provider types-i.e., not just physicians-being able to utilize telehealth/telemedicine technologies to care for their patients,” Lerman says.

In addition, many states continue to work to remove some of the traditional regulatory barriers related to where telehealth/telemedicine services may occur and how provider-patient relationships may be established, according to Lerman. 

“States also are starting to delve into regulatory parameters for provision of telebehavioral healthcare services with more specificity, so that providers can understand rules and requirements specific to ‘telepsychiatry,’ or the like, and not just telehealth/telemedicine more generally.”

Another noteworthy finding is the fact that only two states, Connecticut and Massachusetts, have not made any changes to their legal and regulatory framework since EBG’s original 2016 survey, which suggests a lot of legislative (and positive) activity on states’ parts to try and regulate and provide guidance to providers. 

High aspirations

“Reimbursement for telemental and telebehavioral services continues to be a sticky issue for many telehealth/telemedicine providers,” she says. “It’s important to be open to strategies that can include more reimbursement options and bringing in telehealth/telemedicine providers to your networks and, hopefully, expanding your networks in the future to include these providers.”

The telehealth/telemedicine providers Lerman has had conversations with do aspire to be part of managed care and other insurance product networks, in order to reach patient populations who cannot (or are not willing) to pay out of pocket for services.

“With continued regulatory activity in many states, including an increasing number of states enacting parity laws, we are hopeful that managed care executives will be open to strategies that can include more telehealth/telemedicine providers in their networks,” she says.

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