[Transcript] Episode 510: A Potpourri of Updates: Teletherapy, HIPAA, and Medicare

 

Evan Dumas 

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co-host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech. 

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and electronic health record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients remotely, create rich documentation, schedule appointments and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Evan Dumas 

Hello and welcome to Episode 510: A Potpourri of Updates: Teletherapy, HIPAA and Medicare.

 

Liath Dalton 

Hi, everybody. We are doing this little potpourri of updates episode because in the sort of regulatory landscape, we have things that both move at like a glacial pace, and then can move really quickly all of a sudden. And so there are a couple things that we have been tracking and talked about in prior episodes and told you that we would keep you informed when there were developments that were impactful. And so here we are giving that update.

 

Liath Dalton 

So the first one actually happened on a really short timeline, yes. Which is related to, in fact, our very last or most recent podcast episode on the topic of the Medicare expanded telehealth flexibilities and waivers. Which just as of last week, were set to expire at the end of this month, at the end of March, and there had been no news or indicators from any sources related to a move to extend them once again or make them permanent. Which had been things that had been initiated at the end of the Biden term, but then seemed kind of like dead in the water.

 

Liath Dalton 

The great news, though is that the extended flexibilities got kind of tacked into the continuing resolution for government funding so. And that was signed into law as of March 15, so and that very specifically did include the in person requirement for teletherapy, for mental or behavioral health care. I wanted to make sure that it wasn’t just some of the Medicare related flexibilities that got extended, but that the thing that impacts all of you folks was specifically included in that, and it is indeed.

 

Liath Dalton 

So that is really good news, and means that there’s no need to start planning for being able to do in-person assessment with existing clients within the first year of that going into effect.

 

Liath Dalton 

I do still think that it is good to be tracking who your Medicare clients are, that are receiving telehealth and that have not had an in person appointment. Yeah, just kind of incorporate it into your workflow so it doesn’t have to be a big project that’s done at the end of things. You can just sort of roll it out as as you go, and that’ll make lighter work. But that’s the great news.

 

Liath Dalton 

And then I want to emphasize again, that the concerns that had been in place and kind of propagated on social media about those flexibilities, meaning that teletherapy would no longer be covered at all, are totally not true. Those have been made permanent. It’s just the in-person thing that was in question. So as of now, the extension is valid through September 30, 2025. So a six month extension.

 

Liath Dalton 

And absolutely better than nothing. And hopefully they will, um, make a plan for extending it beyond that, or making it permanent, and not leaving it up to the last minute. Given the state of things with with Congress, I don’t have high hopes for that, but I was relieved that even in amidst everything that is going on, and and the sort of debacles, multiple debacles that unfolded around the government funding bill, that this was included. So great news. So rest easy.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Okay, what’s our next update, Evan?

 

Evan Dumas 

Oh yeah, everyone was worried about the new HIPAA Security Rule changes and if they should lobby, things like that. So we got a good update on that for you.

 

Liath Dalton 

Yes. So as we had kind of forecasted, that not only would there be significant pushback in all of the comments while the public comment period was open. Which it was open until March 7, so it’s now closed. But since then, there has now been a letter to President Trump and HHS Secretary Robert Kennedy Jr., basically urging the administration to rescind the proposed updates.

 

Liath Dalton 

And those eight industry associations include the College of Healthcare Information Management Executives, the Medical Group Management Association, the American Healthcare Association, and the Health Innovation Alliance. So big stakeholders. And, kind of, all of the assessments based on this letter and the current regulatory environment, in terms of Trump’s, or the Trump administration’s focus on re-examining regulations and trying to bring about deregulation rather than further regulation, there’s kind of an emerging consensus that the proposed rule’s future is very uncertain and looking less and less probable.

 

Evan Dumas 

Definitely less. Yeah.

 

Liath Dalton 

Yes. So take, take a breath regarding the concerns that all of the sort of specificity of the proposed rule’s new requirements generated. Though, I’m going to call back to what we said in the episode dedicated to those proposed rule changes, which is that a lot of them are really reasonable and appropriate and should just be implemented in order to safeguard client info and safeguard your practice.

 

Liath Dalton 

So while they may not be explicitly required at this point in time, the majority of them are not too hard to put in place and will really protect you from, you know, data breaches and everything that gets impacted by that, including the practice’s, reputation and client trust and so on. So just because it’s not an imminent requirement doesn’t mean that we shouldn’t be

 

Evan Dumas 

Good ones.

 

Liath Dalton 

active, actively engaged in the security and risk management process and trying to continually be assessing risks, what the threat landscape is, and what measures we can put in place to prevent against them.

 

Evan Dumas 

That’s a helpful tool.

 

Liath Dalton 

And when it’s when it’s engaged as an ongoing process, that it’s a lot less overwhelming. And there are ways where it can can strengthen your practice beyond just safeguarding client info, but it can also help streamline efficiency and operational processes.

 

Evan Dumas 

Exactly, to make things easier.

 

Liath Dalton 

Yeah, and we want things to be easier. Wherever it’s possible to have things be both easier and better, that’s the ideal. And we would say that juice is worth the squeeze right?

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Now, we do have some exciting developments at this point as well, related to teletherapy cross jurisdictional practice and that getting opened up for counselors and for licensed clinical social workers, finally.

 

Liath Dalton 

So it’s been in the works, both the Counseling Compact and the Social Work Licensure Compact have, since 2024, early 2024, or actually late 2023, had enough states that has enacted the legislation to go into effect. However, they have not yet been operational. Meaning clinicians have not been able to apply for the practice privileges under the Compacts and use them to do cross jurisdictional practice under the auspices of the Compacts. And there has been scant news or timelines specified for when the applications will open up and when they will become effectively operational.

 

Evan Dumas 

Yeah.

 

Liath Dalton 

That’s just changed! Which is so exciting.

 

Liath Dalton 

So for the Counseling Compact, the timeline that they are giving for the compact privileges to practice being opened is late summer or early fall 2025. So basically within three to six months from now, which is fantastic.

 

Liath Dalton 

One thing to note though about the Counseling Compact, which is distinct from PSYPACT, the cross jurisdictional practice for psychologists and for the Social Work Licensure Compact is that getting privileges to practice through the Compact is done on a state by state basis. So you have to make a application for each state, each member state of the Compact that you wish to practice in.

 

Liath Dalton 

Unfortunately, it’s not the sort of blanket authorization to practice in all member states that the PSYPACT has or that the Social Work Licensure Compact will have. So it’ll involve some more some more paperwork, some more processes, potentially some more fees, but it’s still going to really open up practice, which is fantastic news.

 

Evan Dumas 

Yeah, it’s gonna be a little bit of work, but I think it’ll be so worth it for so many people.

 

Liath Dalton 

Absolutely. And the second piece of good news related to compacts going into effect is that the Social Work Licensure Compact also has finally specified their target date for being operational and applications being open. And their target date is specified currently as fall of 2025. So sometime, basically between, what, four and eight months.

 

Liath Dalton 

Yeah,

 

Liath Dalton 

Maybe, about that?

 

Evan Dumas 

Yeah, and we’ll see. I mean, it’s a target date. So yeah, whatever that means.

 

Liath Dalton  

And, and we, you know, to, to be fair, have seen target dates not get met, and get shifted, and get shifted at the last minute. And I will say that while, of course, that’s frustrating for the folks who are the end user and waiting to be able to utilize it, it also is not uncommon and kind of the reality when having to have developers build a technical infrastructure to support everything.

 

Liath Dalton 

This is why PCT does not like to give any specific dates for when a new, new feature or something will be launched, and rather, just do it by surprise,

 

Evan Dumas 

It’s ready when it’s ready.

 

Liath Dalton 

Ready when it’s ready, yes. But we’re really thrilled to see there be timelines, target timelines, specified now for both the Counseling and Social Work Compacts. And that those are prior to the end of this calendar year. So that’s awesome news.

 

Liath Dalton 

And also just do a little related shout out, which is that Person Centered Tech does an annual Continuing Education training on Cross-Jurisdictional Teletherapy Practice and navigating the legal ethical considerations related to it. Our 2025 edition will be presented live on Friday, March 28, and then also available as an on demand, self study, CE course.

 

Liath Dalton 

And in that, we will be addressing both temporary practice provisions, the licensure compacts and their impact, some of the new case law related to teletherapy. And we’ll be looking at international teletherapy. Both when you have, where your clinicians have clients who are outside of the US, or something that is increasingly popular is, and I can’t imagine why, Evan, is providers wanting to live overseas, outside of the US, but continuing to practice under their US license or licenses. So we’ll be addressing that, both in the context of your general licensure provision, the compacts and the way that can impact insurance billing as well.

 

Liath Dalton 

So check that out. We’ll link to the course brochure and registration in the show notes, along with some relevant stories for more in depth information on each of the updates we’ve given.

 

Liath Dalton 

We hope you found this helpful and reassuring, and we look forward to chatting with you folks next week. Take care everybody.

 

Evan Dumas 

Yeah, talk to everybody next week.

 

Liath Dalton 

This has been Group Practice Tech. You can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast, or click podcast on the menu bar.