Regulatory Tips for Improving Access to Healthcare During COVID-19
On March 13, 2020, the White House declared a national emergency in response to the outbreak of the COVID-19 virus (coronavirus). Federal, state and local agencies across the country are moving swiftly to address the pandemic by enacting policy changes to “flatten the curve” of the disease’s spread.
Current medical best practices advise diagnosing, testing, and quarantining people with virus symptoms early to prevent its spread. In order to ensure the success of these medical efforts, there must be increased access to health care providers.
Esper’s indexed database of state and federal policies provides information on policymaking across the United States. Esper’s research has identified the following policy areas that can be updated to increase access to health care professionals and save thousands of lives:
- Telemedicine regulations
- Nurse licensure compacts
- Certificate of need laws
Telemedicine
Telemedicine refers to the use of teleconferencing to administer medical diagnosis and care. In the time of COVID-19, telemedicine helps decrease the stress on the overall medical system by reducing more routine visits to medical facilities. It also helps deliver care to rural areas without immediate access to physicians.
On March 10, 2020, Massachusetts Governor Baker issued an executive order making sweeping changes to telemedicine regulations, requiring the following:
- All commercial insurers, self-insured plans, and the Group Insurance Commission to cover medically necessary telehealth services.
- Payers are prevented from imposing restrictions on the technology used to deliver telehealth services and reimbursing services delivered via telehealth at a lower rate.
- Payers cannot impose cost-sharing via copayments, deductibles, or coinsurance for COVID-19 treatment delivered using telehealth.
- Prior authorization is not required to receive medically necessary treatment of coronavirus by in-network providers using telehealth
Regulators can immediately focus on cross-state licensing, online prescribing, and patient consent requirements. All of these policies can create unseen barriers to care and can be amended or waived in the current climate to increase the number of medical practitioners able to serve their communities.
Nurse Licensure Compacts
States use licenses to regulate individuals allowed to lawfully operate as doctors, nurses, and other important roles in our healthcare system. Some states establish their own specific guidelines whereas other states have entered into multi-state compacts that enable practitioners to move and practice across state borders in applicable states.
The disparity in licensing requirements makes it difficult for healthcare professionals to cross state lines and legally treat patients. In a time of increased medical demand, governments are expediting or even waiving stringent guidelines to allow more medical professionals to practice in multiple jurisdictions.
On March 14, 2020, Texas Governor Greg Abbott directed the Texas Medical Board and Texas Board of Nursing to fast-track temporary licensing for out of state physicians, nurses, and other healthcare professionals. This move will increase the number of medical professionals able to diagnose and treat sick patients.
Certificate of Need Laws
Certificate of Need, or CON, regulations require formal approval before the construction of new healthcare facilities. CON rules seek to keep prices low by ensuring there isn’t a proliferation of empty facilities that can result in inflated prices due to the fixed operating costs of a given healthcare facility.
There is already a surge in hospital beds in use, and in worst-case scenarios, facilities could run out of hospital beds and have to turn sick patients away. We need to construct health care facilities quickly in anticipation of caring for an increased number of patients. Getting a Certificate of Need is a time-consuming process, and regulators should consider waiving these requirements in order to expedite the set up of temporary health care facilities.
On March 12, 2020, the North Carolina Department of Health and Human Services lifted a CON regulation requiring hospitals to get permission to add more beds. Without this waiver, applying for and receiving a CON would cost up to $500,000 and take months to be approved.
These policy changes showcase the chance that policymakers have to make a difference in combatting this disease by unlocking the healthcare resources across the country. Policymakers should review their existing policies to ensure their government is fully supporting and serving the brave medical workers facing COVID-19 in practice. Our team thanks all of those who are providing care and support now.
If you are a policymaker tasked with efforts to stem the effects of COVID-19, contact support@esper.com for free access to Esper’s policy database or for a free consultation on your government’s regulations.
Note: The examples above are just a few ways in which regulators can act in response to COVID-19. Below, we list federal and state regulatory actions recently enacted to support the health crisis:
- FDA allows state leeway in virus testing
- FDA loosens regulations on distribution of newly developed tests
- DOT provides hours-of-service regulatory relief to commercial vehicle drivers transporting emergency relief
- Not all test kits required to be sent to a CDC lab
- TSA allowing hand sanitizer containers up to 12 ounces
- Allowing patients to have access and control over their medical data by loosening HIPAA requirements
- Allowing out-of-state doctors to treat patients through telehealth
- Easing restrictions on online courses at colleges and universities
- Maryland — Established interstate reciprocity for health care licenses
- Maryland — Inactive practitioners allowed to practice
- Massachusetts — Allowance of some pharmacies to make hand sanitizer
- Massachusetts — Licensed medical workers able to get Mass. licenses in one day
- Massachusetts — Allowance of expanded telemedicine
- Texas — Fast-tracking the temporary licensing of out-of-state physicians, physician assistants, certain retired physicians, nurses, and other license types
- North Carolina — Lifted “Certificate of Need” law regarding hospital beds
- South Carolina — Issuing of “emergency” nursing and medical licenses to combat COVID-19
- Mississippi — Mississippi State Board of Medical Licensure to lift restrictions that will help reduce doctor-patient contact and allow telemedicine
- Oregon — Renewal of medical licenses
- Colorado — Expedited medical licensing
- Colorado — Interstate reciprocity for health care licenses
- Tennessee — Established interstate reciprocity for health care professionals
- New Hampshire — Expansion of access to Telehealth Services
- Washington — Allows for out-of-state licensed professional to volunteer in Washington
- Iowa — Reduced number of hours of experience needed for medical students to obtain a license if the higher education institution approves
