During the public health emergency, both federal and state governments relaxed restrictions on telehealth services in order to increase access to care for many patients. This led to exponential increases in the number of people using telehealth.
The public health emergency ended last month, leaving both providers and patients with questions about the future of telehealth. Both the federal and Connecticut governments extended most telehealth measures for at least another year, but then they are set to expire.
State telehealth policies
In March 2020, Gov. Ned Lamont signed an emergency waiver relaxing state telehealth regulations to enable more people to get medical care without leaving their homes.
Among other provisions, the law permitted licensed providers from other states to provide telehealth services to Connecticut residents.
The measure also prohibited insurance carriers, including private companies, from reducing reimbursement for services just because they were provided through telehealth instead of in-person.
This meant that if, for example, someone chose to speak with their primary care provider via a telehealth appointment instead of going into the office, their insurance could not pay the physician less just because it was a video appointment.
During the 2021 session, the legislature passed a bill extending most pandemic telehealth policies through June 30 of this year. Last year, the legislature again passed a law extending them through June 30, 2024.
However, a spokesperson for the Department of Public Health said the state doesn’t currently have any plans to extend either of those provisions beyond June of next year.
“There are no plans at this time to make these two measures permanent,” stated DPH spokesperson Chris Boyle in emailed comments.
Under the public health emergency waivers, out-of-state providers who received permission from DPH could provide telehealth services to Connecticut residents, and they may continue to do so until June 30, 2024. After that, only out-of-state providers of mental or behavioral health care will be able to do so.
“This exception for mental or behavioral health care providers was designed to help address the shortage of such providers in CT,” said Boyle, the DPH spokesperson.
Rick Martinello, a professor of medicine at Yale specializing in infectious diseases, explained that how much physicians get paid for telehealth services will determine its availability in the future.
“It’s really that reimbursement that’s going to drive accessibility,” said Martinello.
All insurance carriers must continue to reimburse telehealth services on par with in-person services until next June. But what will happen after is less concrete.
More than half of Connecticut residents receive insurance through their employers, so whether private insurers continue with equal reimbursement will determine to what degree most people in the state continue to have broad access to telehealth.
“Health insurers have long recognized the value of telehealth services and were among the first to promote its use,” stated Susan Halpin, a spokesperson for the Connecticut Association of Health Plans, which lobbies on behalf of insurers.
“Exact payment structures, however, may vary according to the carrier and its provider contracts with cost and quality considerations in mind as carriers strive to provide consumers with more affordable premiums.”
For now, Medicaid will continue to reimburse equally for telehealth, according to a spokesperson with the Department of Social Services.
“We are not planning on reducing rates when services are provided via telehealth. That being said, we do want to reserve the right to review this decision as we continue to learn more about telehealth services. However, at this time, we have no plans to cut the rates for telehealth services,” said Jalmar De Dios, a DSS spokesperson.
Federal telehealth policies
The federal government extended most of the telehealth waivers for Medicare through December 31, 2024. This means that, for another year and a half, Medicare patients can continue to access telehealth services in any geographic region, rather than only in rural areas. They can also remain in their homes for telehealth visits, rather than being required to travel to a health care facility.