Prescriptions
Another exception that expired at the end of the PHE is the Drug Enforcement Administration (DEA) exception to requirements for separate DEA registrations in all states where patients being prescribed controlled substances by telehealth are located.
During the PHE, if a clinician was registered with the DEA in any state, they did not need to register in other states where they were prescribing or dispensing controlled substances via telehealth, if state law allows. When the PHE expired, clinicians again need to register with the DEA in all states in which their patients are located.
An in-person medical evaluation is also again required to prescribe Schedule 2–5 substances via telehealth.
Delayed Changes
Happily, many more telehealth changes post-PHE won’t take effect until the end of 2024. One telehealth policy that will remain through Dec. 31, 2024, is the ability to provide telehealth services to patients regardless of their geographic location. The ability to provide services across state lines has been a popular option for some practices during the pandemic; however, the HHS cautions that this allowance is subject to state laws, which may prevent interstate telehealth services.
Also extended until Dec. 31, 2024, is the ability to provide telehealth services to Medicare patients in their homes, as well as audio-only telehealth services to patients. The HHS has provided guidance for how audio-only telehealth can remain compliant after the OCR’s enforcement discretion ends.
Importantly, clinicians should note that landlines will not violate HIPAA, whereas cell phones or other electronic communication technologies may.
Clinicians should also take reasonable steps to ensure their audio-only service is private, that the patient’s identity is verified and that auxiliary aids or services be used as appropriate to ensure the effectiveness of the communications.
No Change Expected
Some telehealth changes made as a result of the PHE will remain in place permanently. Most of these deal with the provision of behavioral health or mental health services. However, with any of the changes made as a result of the PHE, it is important to stay informed as to any other extensions or guidance that may be implemented even after the end of 2024. As industries adjust their businesses post-PHE, additional action may be taken by federal or state governments to preserve popular telehealth changes.
As the PHE comes to an end, it is a convenient time to consider telehealth best practices. Over time, enforcement agencies may be less sympathetic to claims of “trying to do one’s best” when it comes to telehealth services. To prepare, take time now to review your telehealth policies, procedures and training, and ensure you have adequate privacy and security for telehealth services.
