How Mental Health Care Is Impacted When Federal COVID Emergency Ends in May

The U.S. government has announced that the federal COVID-19 pandemic public health emergency (PHE) declarations will officially end on May 11. 

This end to the federal emergency declarations will have significant impacts on practitioners and mental health care.

Interstate Practice

During the public health emergency, the U.S. government had allowed Medicare providers to practice across state lines. 

Some therapists mistakenly believed this meant there was a broader federal approval of telehealth therapy practice to treat clients across state lines. However, the public health emergency did not actually make permissions for interstate video therapy. Rather, it facilitated payment for therapy services if those services were otherwise deemed legal.

Some states, including Oregon and South Dakota, passed 2020 emergency licensure waivers to allow mental health practitioners licensed in other states to practice within these states during the pandemic. Alas, most, if not all, state-level COVID emergency declaration exceptions have now expired.

So, as we return back to state laws, as they were before the public health emergency, it’s essential to remember that most U.S. states view a therapy session as taking place in the state where the client is physically located at the time of service. 

If you’re not qualified (either by licensure or through a current waiver in that state’s licensure law) to practice in a state your client is visiting, continuing to provide treatment by telehealth video therapy could be viewed as a legal violation. 

Now, in providing teletherapy sessions across state lines, you could be seen as practicing in that state without a license—an act that, in the worst cases, can result in criminal charges.

Insurance Coverage and Reimbursement Rates for Telehealth

During the time of the federal COVID public health emergency, Medicare and Medicaid provided reimbursements to practitioners for telehealth services at the same rates as in-person care. 

Many private insurers did as well. 

States also took a number of emergency actions to encourage, and, in some states to require, mental health services delivered via telehealth to be covered by insurance.

The American Psychological Association (APA) website has a useful state-by-state list summarizing each state’s guidance for telehealth during the COVID public emergency. 

Now, with the federal public health emergency coming to an end, individual states are “unwinding” and resuming their individual statewide laws, which can vary widely by state. And, insurers are regulated by state laws.

As Kyle Zebley, senior vice president for public policy for the American Telemedicine Association, told Healthcare Finance in January 2023, half of U.S. states passed payment parity laws, while in the other half, commercial plans vary widely regarding what they will cover and the rates at which they’ll reimburse.

This means, some insurers will have the flexibility to pay different rates for telehealth, or in some locations, to not cover telehealth sessions at all. 

 

Enforcement for Telehealth Platforms’ HIPAA Compliance

In March 2020 at the beginning of the national public health emergency, the Department of Health and Human Services (HHS) issued a notification of “enforcement discretion” for telehealth. In practice, this meant HHS did not take action to impose penalties against health care providers and mental health practitioners who were using video platforms for telehealth care that were not HIPAA-compliant. 

At the time, it made sense. The rapid shift to telehealth led many platforms and providers to struggle with heightened demand. 

However, most of the video platforms have adapted and scaled since then. And, at this point, there’s no reason for mental health providers to continue using non-HIPAA-compliant video platforms when secure telehealth software such as SimplePractice are available.

Additional Changes as the Federal Emergency Ends

The end of the federal emergency declarations related to the pandemic will have additional impacts on mental health providers and clients. 

Many of us have gotten accustomed to free COVID-19 tests at our local pharmacies. Alas, testing and treatment for COVID-19 will become subject to regular insurance rules in most locations. 

The Kaiser Family Foundation has a useful rundown of the various changes for Medicare, Medicaid, CHIP, and other insurers as the federal emergency comes to an end.

Benefits of Using a HIPAA-Compliant EHR Like SimplePractice 

If you’ve been considering trying out a fully integrated, HIPAA-compliant EHR, SimplePractice gives you everything you need to ensure HIPAA-compliant booking, billing, secure messaging, and telehealth. 

Used by over 185,000 private practice clinicians nationwide, SimplePractice is the practice management software for therapists, speech-language pathologists, occupational therapists, and other practitioners in the health and wellness industry.

Sign up for a free 30-day trial. No credit card needed.

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