The May 17, 2023, introduction of the Protecting Rural Telehealth Access Act by Congressman Jake LaTurner and colleagues is a notable stride forward in fortifying rural healthcare. Those colleagues include Representatives Chris Pappas (D-NH), Lisa McClain (R-MI), Marcus Molinaro (R-NY), Alex Mooney (R-WV), and Zach Nunn (R-IA). This bipartisan legislation has important ramifications for psychotherapists offering telehealth in rural areas, particularly Kansas, as it paves the way for more accessible, cost-effective, and time-saving telehealth services.
This legislation, a direct response to the expanded healthcare services in response to the COVID-19 pandemic, provides a unique opportunity for psychotherapists to develop and enhance their rural telehealth practices through outpatient service departments associated with rural critical care access hospitals. Outpatient services offered by a critical access hospital can typically include various diagnostic, therapeutic, and preventive healthcare services, including behavioral care.
Provisions of the Protecting Rural Telehealth Access Act
In particular, the Protecting Rural Telehealth Access Act attempts to bolster and ensure the permanence of Medicare coverage for telehealth services in the following ways:
- Eradication of Geographic Limitations: The Act eliminates geographical barriers related to the location of patients, known as originating sites, making it possible for patients to be treated from the comfort of their homes. This is a significant shift from pre-pandemic regulations, where home-based care was permissible under Medicare and certain Medicaid programs only for specific services and solely for the patient, not the healthcare provider
- Direct Billing by Critical Access Hospitals (CAHs): The Act authorizes CAHs to bill for telehealth services directly, enhancing financial accessibility and viability
- Role of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): The Act permits RHCs and FQHCs to function as distance sites for telehealth services, extending the reach of these services in rural areas
- Expansion of Audio-Only Services: The Act broadens coverage to incorporate audio-only services for the purposes of evaluation and management, as well as behavioral health services, thereby accommodating patients with limited access to video-enabled devices or stable Internet connections.
Implications for Rural Psychotherapists
Here are five recommendations for psychotherapists as they navigate this evolving rural telehealth landscape:
- Leverage Home-Based Therapy: The Act removes geographic restrictions, enabling patients to receive treatment from their homes. Psychotherapists should capitalize on this opportunity to extend their services to those unable to travel or uncomfortable with office-based therapy
- Explore Direct Billing: The legislation allows Critical Access Hospitals (CAHs) to bill directly for telehealth services. Psychotherapists affiliated with CAHs should familiarize themselves with this process to ensure smooth billing operations
- Foster Relationships with Rural Health Clinics and Federally Qualified Health Centers: The Act permits rural health clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distance sites for telehealth services. Developing relationships with these institutions could extend the reach of psychotherapy services in rural areas
- Embrace Audio-Only Services: The legislation expands coverage to include audio-only services for evaluation, management, and behavioral health services. This can be especially useful for clients with limited Internet access. Psychotherapists should prepare themselves for this medium, understanding its benefits and limitations
- Stay Abreast of Legislative Changes: The dynamics of rural telehealth are subject to change as this legislation evolves. Psychotherapists should keep informed of any modifications to continue providing optimal services and maintain compliance with regulations. Telehealth.org offers telehealth and technology-related email newsletters to professionals in all 50 states at no charge.
It’s important to note that the specific services offered by outpatient critical access hospitals may vary depending on the hospital’s resources, capabilities, and the needs of the local community they serve.
This legislation has the potential to significantly enhance the quality and accessibility of psychotherapy services in rural communities. Psychotherapists should capitalize on these opportunities to advance their practices and improve mental health care in these underserved regions.
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