Telehealth and Virtual Care Updates by State

Fall has arrived, and just like the changing leaves, we’ve seen some noteworthy shifts in regulations and policies governing telehealth and virtual care. From Delaware's new registration requirements for out-of-state practitioners prescribing controlled substances to Illinois allowing physical therapy via telehealth, there is, as always, lots of new information to keep track of. But don’t worry! We’re here to help!

Before expanding on these updates, a quick heads-up: 

Rebecca E. Gwilt and Michael Pappas will be attending HLTH in Vegas the week of October 20th and are available for meetings. Feel free to reach out to them directly if you would like to connect!

Now, let’s get into the substance:

Delaware

Requires Out-of-State Practitioners Prescribing Controlled Substances to Register

TLDR: Effective August 29, 2024, Delaware has expanded state registration requirements for the prescription of controlled substances to include out-of-state practitioners, including practitioners who are practicing within the state under an interstate compact license, telehealth registration, military license, or are granted practice privileges within the state. These providers now must register with the state every two years. Delaware intends to regulate all prescriptions of controlled substances to Delaware patients. 

Key Takeaways:

• Out-of-state practitioners practicing in Delaware must now register with the state in order to prescribe controlled substances. Check out the full revisions here.

Illinois (2)

Permits Physical Therapy through Telehealth Services

TLDR: Effective January 1, 2025, Illinois will allow physical therapy to be provided via telehealth under certain conditions. However, initial physical therapy assessments must be performed in person unless telehealth services are necessary to address a documented access to care hardship. The use of telehealth as a primary means of physical therapy is an exception that requires documentation of clinical justification. Finally, a patient receiving physical therapy via telehealth has the right to request and receive in-person treatment at any time, and any telehealth physical therapy provider must be able to provide in-person care within Illinois.

Key Takeaways:

• While physical therapy for patients via telehealth is now permitted to enhance access to care, it should be used as the exception rather than as the primary means for delivering therapy.
• Both physical therapists and physical therapy assistants working under the general supervision of a physical therapist may provide care through telehealth services.  
• A patient’s request for in-person care must be honored at any time.
• Check out the full revisions here.   

Nevada

Revises Supervision Requirements for Psychological Assistants, Interns, or Trainees

TLDR: Adopted on August 13, 2024, the Nevada Board of Psychological Examiners amended the supervision requirements for psychological assistants, interns, and trainees. In addition to altering the training and practice time requirements to become a qualified supervisor, the Board has also amended the requirements for the type of supervision that must be provided. Previously, Nevada had required psychologists who intended to act in a supervisory role to complete “training in clinical supervision” without elaborating on what type of training is required. The Board has clarified the requirements to include 15 hours of continuing education (“CE”) in supervision of psychological assistants, interns, and trainees; one semester of supervised supervisory experience; a graduate level course in supervision; or any combination of the aforementioned experiences that is approved by the Board. Additionally, previous regulations had authorized that a supervising psychologist for a particular site could utilize the presence of another licensed behavioral health provider to conduct supervision only if that provider was physically present. Now, the licensed behavioral health provider need only be affiliated with the site. The Board has also decided to prohibit a psychologist from supervising more than four full-time equivalent assistants, interns, or trainees at one time.   

Key Takeaways

• Psychologists must now complete 15 hours of Continuing Education in order to supervise assistants, interns, or trainees.
• A supervising psychologist may utilize a licensed behavioral health provider affiliated with their practice site to supervise. 
• A psychologist may supervise no more than four full-time assistants/interns/trainees at one time.
• Check out the full revisions here.

Idaho

Adds Requirements for Provider Reimbursement under Medicaid Basic Plan Benefits

TLDR: Effective July 1, 2024, Idaho has added additional conditions for reimbursement for all providers of medical care and services who submit a claim under Medicaid Basic Plans. These conditions include requirements that all services delivered via virtual care be identified as such in order to be reimbursed.

Key Takeaways

• All services delivered via virtual care pursuant to Idaho Code Tit. 54, Chp. 57 must be identified as such and will be reimbursed in accordance with limitations set out by the Idaho Medicaid Provider Handbook. Virtual care services that are not identified as such will not be covered. 

Check out the full revisions here.