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4:13 PM, Feb 27, 2020

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Changes to telehealth rules leave mental health patients in flux

Posted at 9:45 AM, Oct 21, 2022
and last updated 2022-10-21 09:45:53-04

(WXYZ) — We are in a new phase of the COVID-19 pandemic and with the public health emergency over, there are also important changes to telehealth.

According to the Alliance for Connected Care, a telehealth industry trade group, Michigan is one of the more than 40 states that have ended emergency waivers.

That means patients who found out-of-state providers during the pandemic have to scramble to find new care.

Wixom resident Susy Becker suffers from anxiety and depression and says many of the psychiatrists in her area treated her mother, and that made it tough for her to find care.

"When COVID hit, all of a sudden, there was a chance for me to actually find a provider," she said.

That came in the form of an out-of-state psychiatrist and a counselor using telehealth to provide medication and therapy.

"It has gone extremely well. The problem was, in July of this year, I was told that I could no longer see my counselor," she said.

Dr. Chad Ellimoottil, the medical director of virtual care for the University of Michigan Medical Group, says that's because the waivers and license flexibilities from early in the pandemic are being rolled back.

Back then, virtually all states allowed providers licensed in other states to practice.

The rules around state licensing are archaic. And the reason for that is that they were developed at a time when telehealth didn't exist," Ellimoottil said.

That means a provider has to pay and maintain a license in every state where they have a telehealth patient and know and comply with each state's rules.

"The system is still very clunky. Ideally, you should be able to get care from your healthcare provider no matter what state you're in. And unfortunately, we're not quite there yet," he said.

People seeking care in areas where there's a shortage of providers are most impacted. That includes people in rural communities, people who live near state borders, and more.

"We are in a mental health provider shortage, there's no doubt about it, especially with the pandemic," Ellimoottil said.

Efforts to make telehealth easier nationally and among the states have been slow. Ellimootil says one possible fix is to allow telehealth with bordering states since research shows more than 60 percent of out-of-state telehealth visits occur in states next door.

For Susy, the message is simple: everyone should be able to get the help they need and where that help comes from shouldn't matter.

"I may be one person, but I know I'm not alone," she said.

Insurance is also a factor. Out-of-state providers may also be out of network, and that can lead to nasty surprise bills.

Fixing this issue will require work nationally and at the state level.

While few object to telehealth - Ellimootil says right now very few are incentivized to really work on the issue, and that leaves patients like Susy stuck searching for the help they need.

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