States take Extensive Health IT Actions on COVID-19

By Alana Lerer, MPH, CAHIMS, Manager, Government Relations, HIMSS

As the number of confirmed cases of coronavirus (COVID-19) continues to grow, state policymakers in the United States are taking extensive actions to manage the spread of the virus through information and technology. These actions primarily focus on increasing access to telehealth to connect patients and providers virtually throughout the duration of the declared public health emergency. Other actions include supporting public health surveillance and electronic case reporting to improve disease tracking and management.

The federal government is also taking important actions on telehealth. Read more: Telehealth in the COVID-19 Spotlight.

HIMSS is continuing to monitor state and federal actions, since policy changes are occurring daily.

State Actions on Telehealth

As of March 17, states have taken the following actions on telehealth:

• Licensing waivers for telehealth relating to COVID-19 (Arizona, California, Florida, Louisiana, Maryland, Mississippi, North Carolina, Tennessee, and Washington)

States are waiving in-state licensing requirements for providers delivering telehealth, per specified terms and conditions. For example, in Florida, with approval, out-of-state providers may deliver services through telehealth to Floridians without attaining a license throughout the duration of the public health emergency.

• Changes in Medicaid coverage (California, Connecticut, District of Columbia, Louisiana, Maryland, Massachusetts, Michigan, Missouri, New York, and West Virginia)

States are expanding access to telehealth for Medicaid recipients. These policies include loosening the limitations of originating site (location of patient), requiring that provider reimbursement for telehealth be the same as that of a traditional in-person visit, and allowing for multiple methods of telehealth, such as telephone without the requirement of video.

• Changes in Commercial/Private Insurance Coverage (Arizona, Colorado, Maryland, Massachusetts, Michigan, Minnesota, New York, Pennsylvania, and Texas)

States are also mandating that commercial insurance carriers cover telehealth throughout the duration of the declared public health emergency. This may include waiving all copays, coinsurance, and deductibles for patients relating to COVID-19 diagnostic testing and requiring provider reimbursement for telehealth be the same as reimbursement for a traditional in-person visit.

• Guidance for existing coverage (California, District of Columbia, New York)

States that have previously expanded access to telehealth provide guidance for healthcare providers.

The Center for Connected Health Policy has a helpful resource for additional information on telehealth at the state and federal levels.

Additional Health IT State Actions, as of March 17

Besides telehealth, states are beginning to appropriate funds for surveillance to detect and manage the outbreak and require electronic case reporting to public health entities.

• Arizona: (Proposed) Allows the governor to issue an enhanced surveillance advisory, which requires reporting cases, tracking patients and information sharing with relevant parties.
   
• California: State entities are authorized to share relevant medical conditions, as necessary to mitigate the COVID-19 outbreak with governmental and nongovernmental partners for the limited purposes of monitoring, investigation and control and treatment and coordination of care.
   
• Indiana: (Proposed) Appropriates $5 million for the prevention, surveillance, treatment and containment of the COVID-19
   
• Michigan: (Proposed) A health professional must report coronavirus cases to the Michigan Department of Health and Human Services within 24 hours.
   
• North Carolina: Executive order to implement surveillance and control measures for individuals who have been diagnosed with or are risk of contracting COVID-19

These policy changes at the state level are key levers to manage the spread of COVID-19. As the crisis continues, it is imperative other states follow suit to effectively manage this public health emergency.