Connecticut's New Telehealth Law Sees Long-Term Policy as a Work in Progress

Telehealth advocates are cheering Connecticut Governor Ned Lamont’s extension of pandemic-related telehealth coverage for another two years, saying it gives providers more time to develop long-term strategies for connected care services.

Lamont’s signature on HB 5596 extends until June 30, 2023, an emergency provision he’d signed in March 2020 to help providers address COVID-19. Among other things, the law allows a variety of providers, including dentists, therapists, physician assistant and behavioral healthcare providers, to use telehealth, permits audio-only telehealth services and allows licensed providers from other states to treat Connecticut residents via telehealth.

“Throughout the last year, patients across Connecticut have found that connecting with their medical providers through videoconference or telephone has been incredibly beneficial and practical for a wide variety of reasons, so it absolutely makes sense to allow for these services to continue,” Lamont said in a press release. “Making it easier for people to connect with their doctors or medical advisors is a goal that we should strive to attain. I appreciate the state legislature for recognizing the benefits of the emergency executive order that I signed at the beginning of the pandemic, and I appreciate their bipartisan cooperation in passing this legislation so that I could sign this into law today and these relaxed telehealth rules can continue.”

With this legislation, Connecticut joins dozens of states either extending emergency telehealth coverage or even making those provisions permanent. In doing so, they’re recognizing that the fast-paced expansion of telehealth services during the crisis is helping providers improve access to care and care management.

“Generally, providers are very pleased with the two-year extension,” says Richard Albrecht, director of the telehealth network for the Community Health Network of Connecticut, a network of federally qualified health centers and an associated health plan that has seen telehealth use soar during the past year and a half.  “This provides sufficient time for … for health centers to re-normalize care delivery in a post-pandemic environment, where telehealth will continue to be a vital care-access channel (and it cerates) time for payers and regulators to gather sufficient quality, efficacy and best practices data to inform a thoughtful long-term telehealth policy.”

It’s that “long-term telehealth policy” part that’s worrying some advocates, however. So far, Congress hasn’t acted on the dozens of telehealth bills on Capitol Hill, despite intense lobbying from organizations and providers and more than a few hearings. And that’s keeping some health systems from making long-term connected health plans.

Some worry that the underwhelming advances in telehealth coverage seen in pandemic relief legislation and the Centers for Medicare & Medicaid Services’ 2021 Physician Fee Schedule may signal continued reluctance to take action. After all, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021, introduced last month, supported by more than half of the Senate and touted as the most comprehensive telehealth bill out there, failed to make it through three previous iterations.

In a worst-case scenario, Congress won’t act, and federal guidelines on telehealth coverage and access will revert to pre-pandemic levels. In that case, supporters say, many health systems will scale back or ditch their telehealth programs regardless of their success, and the momentum will die out.

That likely won’t be the case. Lawmakers and members of President Biden’s Cabinet have said that some action will be taken to ensure telehealth is on better footing in the “new normal.” And some states have made their telehealth coverage permanent.

Connecticut’s action is a sign that lawmakers and healthcare providers want to study the landscape a little bit longer before setting things in stone. While many support coverage for services delivered over a phone, there’s still lots of argument over how to reimburse those phone calls and setting limits on that modality. Likewise, license portability is popular now, but there’s plenty of debate for and against licensure compacts, a one-license-for-all strategy and even keeping the current one-license-for-each-state plan as it is.

“There is a widespread sense that telehealth is here to stay, and these next two years offer an opportunity for stakeholders to collaborate in formulating a policy that everyone can live with,” Albrecht says. “I think most providers see the extension as a ‘vote of confidence’ for telehealth by our legislators, although it comes with an underlying mandate to figure out how to make it work for the long-term, within the next 24 months. We have now have to roll up our sleeves and get that done.”