Corona Virus: All telehealth and crossing the borders outside of our state?
Answered

Hello Simple Practice and fellow Colleagues: I've been hearing rumors, but can't find actual facts. Many of my clients are cancelling due to this Corona Virus. Can anyone tell me if there has been a discussion of ALL insurances covering Telehealth and that we can provide Telehealth outside of our state license during this Corona Virus situation. I thought I'd reach out here before I call all my panicking clients to offer them telehealth as an alternative. Thank you, Jennifer Anderson, MSW, LCSW, BCD Redeeming Grace Counseling, Fargo, North Dakota

 

4 comments

  • 1
    Comment actions Permalink
    Avatar
    Gillian

    Hi Jennifer, because this is a developing situation, we'll be monitoring closely and will provide resources and updates as they become available. 

    Hi Jennifer, because this is a developing situation, we'll be monitoring closely and will provide resources and updates as they become available. 

  • 1
    Comment actions Permalink
    Avatar
    Kimberly Cook

    Hi Jennifer, Here's my thoughts on it. In typical days this is true that you cannot practice in a state where you are not licensed.  And by "practice" in telehealth, that means where the client is located, not necessarily where you are. I believe in the state of Emergency this is lifted.

    Typical: https://www.healthit.gov/faq/are-there-state-licensing-issues-related-telehealth?fbclid=IwAR3laObEwv-gVgSEpGmbElOAlvsb5iZZF2qlyFd2XQ3s0x1VODc8g0zn5Bk 

    State of Emergency: page 4 of this, providers can practice outside of their state of licensure as long as they are licensed in another state. https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf?fbclid=IwAR2ub1vbZQ4RP4OwST5Ur727gWq3RHpllamr7CPsgFu3zm3WB1OTxX5YOcw

    Then, I was asked if this only applies to Medicare and this is my response. 

    The gov’t can’t mandate state licensure related items due to the constitution making professional licensure a states' rights issue. It can control Medicare, Medicaid (to some degree, some is per state), and Tricare as these are federal programs and fed gov’t is the payor. So, typically if feds do something private insurance and states will follow suit but they can’t be forced to by the fed gov’t. Also and equally important, you are unlikely to find a liability lawsuit take root as the federal decisions create a type of legal precedent about what can be considered “best practice.” So, that’s kinda the best we have right now, in terms of whether or not you can practice outside of states where you are licensed, but should create a sufficient safety net for medical professionals. I do not know that there has been much case law precedent for a NATIONAL state of emergency. Document, document, document, consult with peers, and document, and if there’s ever a question you would testify you did what was ethically best for your clients and in keeping with what others in your field were doing and recommending.

    Consult an attorney if you want absolute confirmation.  This is my personal opinion influenced by my social work understanding of ethics and best practice. 

    Kim Cook, LCSW (NC, VA, TN, MD) www.elucc.org

     

    Edited by Kimberly Cook

    Hi Jennifer, Here's my thoughts on it. In typical days this is true that you cannot practice in a state where you are not licensed.  And by "practice" in telehealth, that means where the client is located, not necessarily where you are. I believe in the state of Emergency this is lifted.

    Typical: https://www.healthit.gov/faq/are-there-state-licensing-issues-related-telehealth?fbclid=IwAR3laObEwv-gVgSEpGmbElOAlvsb5iZZF2qlyFd2XQ3s0x1VODc8g0zn5Bk 

    State of Emergency: page 4 of this, providers can practice outside of their state of licensure as long as they are licensed in another state. https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf?fbclid=IwAR2ub1vbZQ4RP4OwST5Ur727gWq3RHpllamr7CPsgFu3zm3WB1OTxX5YOcw

    Then, I was asked if this only applies to Medicare and this is my response. 

    The gov’t can’t mandate state licensure related items due to the constitution making professional licensure a states' rights issue. It can control Medicare, Medicaid (to some degree, some is per state), and Tricare as these are federal programs and fed gov’t is the payor. So, typically if feds do something private insurance and states will follow suit but they can’t be forced to by the fed gov’t. Also and equally important, you are unlikely to find a liability lawsuit take root as the federal decisions create a type of legal precedent about what can be considered “best practice.” So, that’s kinda the best we have right now, in terms of whether or not you can practice outside of states where you are licensed, but should create a sufficient safety net for medical professionals. I do not know that there has been much case law precedent for a NATIONAL state of emergency. Document, document, document, consult with peers, and document, and if there’s ever a question you would testify you did what was ethically best for your clients and in keeping with what others in your field were doing and recommending.

    Consult an attorney if you want absolute confirmation.  This is my personal opinion influenced by my social work understanding of ethics and best practice. 

    Kim Cook, LCSW (NC, VA, TN, MD) www.elucc.org

     

  • 0
    Comment actions Permalink
    Avatar
    Nikkiah Smith

    Hi Jennifer,

    I had the same question.  I read that we had to consult with our state board.  I read the regulations in Virginia and it states that we have to check with the board of the state where the client is located before we can provide telehealth services.  In my case, my client is temporarily working in Arkansas.  I called the board of counseling and the person I spoke to explained that I would not be able to see my client via telehealth despite his situation and despite the COVID-19 pandemic.

    If you have different information, please let me know!

    Hi Jennifer,

    I had the same question.  I read that we had to consult with our state board.  I read the regulations in Virginia and it states that we have to check with the board of the state where the client is located before we can provide telehealth services.  In my case, my client is temporarily working in Arkansas.  I called the board of counseling and the person I spoke to explained that I would not be able to see my client via telehealth despite his situation and despite the COVID-19 pandemic.

    If you have different information, please let me know!

  • 0
    Comment actions Permalink
    Avatar
    Kimberly Cook

    Here's a state by state list for Social Workers.  There's similar lists with other professional boards. https://www.aswb.org/covid-19

    Here's a state by state list for Social Workers.  There's similar lists with other professional boards. https://www.aswb.org/covid-19