Before the COVID-19 pandemic, the use of telemedicine was not widespread, especially for people living in rural areas.  After changes in policies were made at both the federal and state level to expand the use of telemedicine, McKinsey & Company’s Healthcare and Services Division reported that usage increased from 11 percent to 46 percent in the first quarter of 2020 compared to the first quarter of 2019, and the Department of Health and Human Services (HHS) reported that 43.5 percent of Medicare visits were conducted by telehealth in April alone compared to 0.1 percent in February. 

Federal efforts to increase virtual healthcare visits began in March 2020, when Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced that under an 1135 waiver, Medicare would pay physicians to provide telehealth services to all beneficiaries on a temporary basis.  This waiver allows the Department of Health and Human Services to take actions beyond normal activities when the president declares a national emergency under either the Stafford Act or National Emergencies Act.  These services enable Medicare beneficiaries to virtually “meet” with their provider without stepping outside of their home. 

In December 2020, CMS released a Physician Fee Schedule  final rule that would improve payments for additional time doctors spend with patients, as well as expand on the Protecting and Improving Medicare for Our Nation’s Seniors Executive Order issued by former President Donald Trump by permanently expanding telehealth services.

In 2020, many states suspended, waived or eliminated regulations related to healthcare licenses and telemedicine to make it easier to deliver necessary services to their citizens during these uncertain times and in the current mobile society.  Among the states that enabled greater use of telemedicine were New Jersey, South Carolina, and Texas.  Other states, including Maine, Mississippi, and North Carolina allow out-of-state professionals to provide telemedicine to their residents.  Unfortunately, most of the changes were temporary.

In 2021, states have begun work to make telemedicine more available on a permanent basis.  New York Gov. Andrew Cuomo (D) has proposed the elimination of the originating site requirement for the Medicaid reimbursement, as well as the in-person evaluation, along with other measures to incentivize the use of telemedicine even after the current pandemic is over. 

Texas Gov. Greg Abbott (R) said in his State of the State Address that the Texas legislature should work to permanently expand telemedicine, noting it “proved very helpful during the pandemic.”  Sen. Cesar Blanco (D-El Paso) introduced SB 228 and SB 434, which would continue telemedicine options, ncluding the use of smartphones, audio-visual, and other communication systems.  Sen. Charles Perry (R-Lubbock) filed SB 438, which would allow tele-dentistry services to become permanent.

During their current sessions, state legislatures should make the use and availability of telemedicine permanent so individuals who live in remote areas or otherwise cannot immediately get in to see a provider in person have continued access to healthcare.