Ohio weighs whether to make pandemic telehealth rules permanent

More patients have been able to get more types of treatment over video chat or over the phone during the pandemic than ever before. Now state officials are trying to figure out how telehealth should be used long term.

The State Medical Board of Ohio originally set Sept. 17 as a deadline to stop expanded use of telehealth by health officials, giving a three month off ramp after the official state of emergency ended. But after a flood of feedback and concern about COVID-19 resurging, the board just pushed this back to Dec. 31.

Telehealth was already available and used before the pandemic, but use soared starting March 2020 and doctors were able to perform more services such as prescribing medication for a patient they never met during an in-person exam.

ExploreWith skyrocketing demand for telehealth, Ohio Medicaid to make option permanent

There’s some debate on how much the changes are working for patients and providers.

Dr. Amol Soin, medical board member and director of a Centerville pain clinic, said at the August board meeting that he disagrees with the argument that telemedicine is better for patients getting medication-assisted treatment for addiction. He said he thinks there’s a lack of accountability with telemedicine.

“We may be doing the wrong thing by liberalizing telemedicine and keeping it liberal for that particular cohort of patients,” he said. “We have it now, and the (overdose) deaths are soaring.”

Many organizations have called telehealth a needed lifeline specifically for behavioral health patients during the pandemic.

A year ago, Ohio Department of Medicaid cited behavioral health benefits as part of why it moved to make permanent rules to keep expanded telehealth options beyond the pandemic.

“I think it really helped, certainly during the crisis,” said Dr. Dale Block, Ohio chief medical officer for CareSource. “We have access issues already to behavioral health and mental health it became even harder.”

The Dayton-based insurer, which primarily handles Medicaid claims, saw a huge surge in telehealth claims during the pandemic. Block commended the medical board for their transparency and for seeking more information to get the rules right for telemedicine.

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“I think the State Medical Board realized that they needed a much longer timeframe to really figure out what is a permanent solution to telemedicine in Ohio for providers moving forward,” Block said.

Part of what led to the extension of relaxed telehealth rules is not just the need for time to consider what’s next but also the increase in cases. In the Dayton region, hospitalizations and cases have been rising for over a month, and holding doctor’s appointments remotely can help with overcrowding and infection control during the surge.

Medical board member Dr. Mark Bechtel said the current situation is completely different that it was in June, which is when the original September date was selected.

“I think trying to keep our waiting rooms from being overcrowded with sick patients is still a worthy thing to do for public health and safety,” Bechtel said.

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Bill proposes changes

Meanwhile, an bill is pending that would by law expand what can be done via telehealth in Ohio. House Bill 122 is sponsored by Reps. Mark Fraizer, R-Newark and Adam Holmes, R-Nashport.

“The increase in telehealth visits throughout the past year is enough proof to show how instrumental this legislation is for both healthcare professionals and patients,” Holmes stated after it cleared the house in April and headed to the Senate for consideration.

The medical board is working on reviewing telemedicine rules and several medical board members talked about the need to research and proactively shape state telemedicine rules, given the pending legislation.

“People are used to their telemedicine and they like telemedicine and, no offense, but politicians are going to listen to them,” said board member Robert Giacalone, saying the board needs to get on the front end of shaping the rules.

Ohio House Bill 122

Some of what House Bill would change for telehealth in Ohio includes:

  • Expand the types of providers who can use and bill for telehealth services
  • Expand “telehealth” to include email and phone calls, not just a virtual visit, which is the existing law
  • Allow Ohio providers to provide telehealth services to patients who live out of state
  • State there will be no payment parity for telehealth services vs. in-person services

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