Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, outlines the distinct regulatory landscape for mental health telehealth under Medicare, warning that a mandatory in-person requirement threatens access to care in a field already suffering from provider shortages. Congress made telemental health a permanent Medicare benefit at the end of 2020, but the permanence comes encumbered with what Zebley describes as a “clinically inappropriate, mandatory barrier to care.”
The In-Person Requirement Problem
The requirement mandates that telemental health patients periodically see providers in person and then continue receiving care virtually. Zebley calls this requirement illogical and harmful, noting it forces patients to find “a unicorn of a telemental health provider” willing to balance in-person and virtual visits. He emphasizes that the requirement “doesn’t allow for the full advantage of telehealth” and should be “repealed” and “precedent never to be repeated.” The Centers for Medicare & Services has issued some relief: patients with established telehealth relationships before flexibilities expired can continue that care, but new relationships cannot form during lapses in flexibilities.
Policy Disparities
Zebley argues that telemental health should not face different requirements than other medical care. “We are of the belief that we are wanting to empower all health care providers to apply the standard of care consistent with the terms of their state-based license for their profession, to determine for themselves what can and can’t be done appropriately via telehealth.” He contends that given the shortage of mental health providers, imposing an in-person requirement only for telemental health creates unfair discrimination: “It’s not clinically necessary, as I keep hammering. And we should be in a situation where all these services have a level playing field and are appropriately covered and getting reimbursed.”
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.medicaleconomics.com/view/telehealth-on-hold-what-about-mental-health-care-