As emergency orders easing restrictions on telehealth during the COVID-19 pandemic are lifted, patients and physicians are struggling to keep up with rapidly changing rules.
"One of the big benefits of what happened during the pandemic was an expansion, but it was also a sense of clarity. You knew what the rules were, because everything was fine," said Ateev Mehrotra, MD, MPH, a hospitalist and health care policy researcher at Harvard Medical School. "We're about to enter a time where it's very, very confusing because everyone's going to potentially have a different set of rules. And for a telehealth provider, that makes things 10 times worse because you have 10 sets of rules for every state you're in."
Especially in New England, where states are tightly clustered, and in areas where patients regularly cross state borders to receive medical care, "rest stop telehealth visits," in which patients drive into different states to take calls with their providers to legally receive care, are becoming more common. Prior to the increased flexibility during the pandemic, doctors treating patients virtually in states other than where they practice would be required to obtain licenses in each of those states. This puts pressure on physicians to both accommodate their patients and protect themselves from legal issues, causing some to require proof of location, such as a screenshot of their location on Google Maps shared at the start of the telehealth visit.
Some states, including Connecticut and Arizona, are extending temporary telehealth provisions without requiring physicians to apply for new licenses, while others are allowing physicians to practice with the emergency licenses for as long as it takes to receive approval for new ones.
"I would love a telemedicine-only license that would allow me to take care of any established patient anywhere in the U.S.," Stephanie Titus, MD, MPH, a primary care physician in Massachusetts, told STAT.