I want to offer my SMI patients telemental health visits. What is different now because of COVID-19 in terms of regulation and rules?

In mid-March 2020, there were several important changes around telehealth which impact telemental health for SMI. These changes include, but are not limited to: 1) CMS Originating Sites; 2) The Ryan Haight Act; 3) Video visit platform HIPAA rules; and 4) State Regulations. These changes are temporary for the COVID-19 crisis, so be aware that they will change.

  1. Changes to the CMS Originating Sites rule mean you can now see patients from sites including their home for telehealth visits. Before the patient often had to be at a clinic or in a certain type of location. Note this does not mean you can see patients in another state. To learn more at these CMS terms and what they mean, please watch this SMI Adviser webinar: Using Telepsychiatry for Serious Mental Illness: An Introduction (September 2019).
  2. Changes to the Ryan Haight Act mean you can now prescribe a controlled substance without an initial, in person examination of a patient. This means after the first video visit you can offer prescriptions in appropriate. To learn more about the Ryan Haight Act, please watch this SMI Adviser webinar: Using Telepsychiatry for Serious Mental Illness: An Introduction (September 2019)
  3. Changes to HIPAA rules around video visit platforms mean you can now use non-HIPAA secure platforms like Skype to see patients. This does not mean you can use anything and ensuring privacy is still important.
  4. As of March 18th, 2020, it is now possible to use telemedicine across state lines without a medical license. This like all the above changes is temporary so do check with CMS for current rules.

For more details and links, please also see continuous updates from the American Psychiatric Association on telehealth restrictions in response to COVID-19.

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