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Telehealth Wins Parity in Massachusetts: Implications for Your Practice
By Thomas J. Bryant, ARM
President, Physicians Insurance
It took a pandemic to usher in a major change in the way payers and regulators treat telehealth in Massachusetts.
Line one of the slow-to-adopt telehealth parity states, the Commonwealth suddenly became a telehealth policy leader on New Year’s Day when Gov. Charlie Baker signed into law parity for primary care and chronic care services for the next two years, and permanent payment parity for “telemental” health services.
Baker said he felt telehealth should be an accepted standard of care, with full payment parity. The mental health care parity is especially vital for patients coping with COVID-19 mental health issues, and ongoing substance abuse issues requiring urgent treatment, he said.
“I’ve thought for a long time that because as a country we underinvest in primary care and behavioral health services a lot of people who could be treated in the community end up in the hospital and we will basically have a chance here to study this question,” Gov. Baker said.
The need for telehealth services during the COVID-19 pandemic can be credited for more widespread use and acceptance, but the effects on practice management will almost certainly not subside when virus levels do.
The two-year provision was meant to allow the state, physicians and payers time to negotiate longer-term agreements of telehealth coverage, and cope with how the delivery of remote care fits into value-based care concepts that drive payment rates. (For a deeper dive into the regulations, this Jan. 19, 2021 National Law Review article sums it up well.)
We wrote back in October 2020 about some of the basic questions that practices need to consider regarding telehealth, but with the recent changes it seems timely to narrow in on the risk factors that must be most urgently considered by physicians in terms of patient safety, and how they can most effectively be mitigated.
We will focus on three areas of concern, and provide you with some resources that may help your practice manage this concern.
Renewed attention to documentation:
Complete and accurate charting has always been vital for maintaining continuity of care and defending claims of professional liability. And the rise in the use of Telehealth might contribute to an increased risk of diagnostic errors. As the political and payment climate around telehealth continues to shift for the foreseeable future it is especially vital that practice managers stay vigilant with record keeping to mitigate risk of complaints and lawsuits from licensing boards, patients, health systems investigators. This is not the time to cut corners in your medical record retention policies or in your record storage practices.
Ensuring your telehealth products are continually evaluated for security and HIPAA compliance:
The new telehealth laws do not change the fundamentals of security and HIPAA compliance issues. However, with the expected steep increase in technology usgae, a full audit of your products and the company’s ability to support your practice may be in order given the extra demands of so many new customers.
Regulatory environment:
Telemedicine delivery regulations have also remained fairly stable, with existing straightforward regulations about clear and existing patient-physician relationships if the patient lives in the state where the doctor holds his or her license. Be extra cautious about an increasingly common issue in New England,of patients from other states seeking telemedicine services from Massachusetts providers. Regulations governing telehealth in NH, RI, CT, and VT are not identical to those in the Commonwealth and need to be considered carefully.
Here are some helpful resources:
The Massachusetts Medical Society resources on Telehealth and Virtual Care and COVID-19
Coverys on Telemedicine and COVID-19: Managing the Risk
Integris (Formerly CMIC) Blog on Telemedicine Information, Recommendations, and Consent Form
In future editions of The Informed Practice, we’ll explore how to keep the patient-physician relationship vital in an era of remote medicine, and other concerns. Please email Meghan Stanley at mstanley@mms.org with any concerns you’d like to see us cover in this space.
Physicians Insurance President Thomas J. Bryant, ARM, is a licensed property, casualty, life, accident, and health broker in all six New England states and was an adjunct clinical assistant professor in the School of Health Sciences at Bryant University during the period from 2016 through 2018. Most recently Tom developed a video presentation on malpractice basics for Harvard Medical School fourth-year students, and he has participated in NEJM Resident 360 virtual panels on topics related to financial matters important to early-career physicians.
Is it time to examine your current policy? What you don’t know can hurt you. For more information on how Physicians Insurance can support your practice and help you mitigate risk, call 800.522.7426.
Please email Meghan Stanley at mstanley@mms.org with any topics you would like to see us cover in this space.
posted February 25, 2021
