Telepsychiatry
NOTE: On this page, we are pleased to share some of our telepsychiatry expertise with those psychiatrists that we do not insure. If you are not insured through PRMS, please do not rely on this information as more than one company’s risk management thoughts. Nothing presented here is legal advice. You should check with your own risk managers.
The White House announced on January 31, 2023 its plan to end the COVID Public Health Emergency (PHE) on May 11, 2023.
NEW:
February 24th, the DEA proposed two new regulations affecting prescribing controlled substances via telemedicine – one general rule for prescribing without an in-person visit, and one rule specific to buprenorphine. For more information, click here for more information, and see the DEA’s Telemedicine Rules Summary.pdf (dea.gov) and highlights for practitioners.
Click here to see an article by the law firm of Foley & Lardner going into more detail.
IF YOU ARE INSURED THROUGH PRMS, CLICK HERE TO ACCESS MORE COMPREHENSIVE RESOURCES.
The federal COVID national emergency did end a few weeks early. But the COVID Public Health Emergency (a separate emergency declaration with many provisions affecting telemedicine) has not ended early - it will still end on May 11, 2023.
The White House has announced its plan to end the COVID Public Health Emergency (PHE) on May 11, 2023. Here’s what you need to know:
- From the White House statement:
“The COVID-19 national emergency and public health emergency (PHE) were declared by the Trump Administration in 2020. They are currently set to expire on March 1 and April 11, respectively. At present, the Administration’s plan is to extend the emergency declarations to May 11, and then end both emergencies on that date. This wind-down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the PHE.”
- When the PHE ends, three currently suspended federal requirements are expected to go back into effect immediately:
- Relating to prescribing controlled substances:
- First, the requirement that there be an in-person visit prior to prescribing controlled substances is expected to go back into effect. You will need to see or have seen a patient once in person prior to prescribing controlled substances, unless one of the very limited exceptions under the Ryan Haight Act or another federal law applies.
- This in-person visit prior to prescribing controlled substances will also apply to those patients whom you started on controlled substances during the PHE without an in-person visit.
- Second, the requirement to have a federal DEA registration in the state where the patient is located at the time of the appointment (in addition to a DEA registration in the state where you are located, if different) is expected to go back into effect.
- First, the requirement that there be an in-person visit prior to prescribing controlled substances is expected to go back into effect. You will need to see or have seen a patient once in person prior to prescribing controlled substances, unless one of the very limited exceptions under the Ryan Haight Act or another federal law applies.
- Relating to telemedicine platforms:
- HHS will re-instate the requirement that telemedicine must be conducted via a HIPAA-compliant platform. This means that you will need a Business Associate Agreement (BAA) from the vendor.
- Relating to prescribing controlled substances:
For more information on these three federal requirements that will go back into effect upon the PHE’s expiration, see our Impact Charts.
Many unanswered questions remain – we will keep you updated as they are answered.
Unfortunately, it is not true. There was a federal Omnibus law passed in December that did extend SOME of the waivers, but ONLY THOSE RELATED TO MEDICARE. Specifically, the Center for Connected Health Policy has an excellent report detailing:
> Which Medicare-related telemedicine flexibilities:
- Become permanent,
- Remain in place on a temporary basis until December 31, 2024, or
- Remain in place until the end of the calendar year in which the PHE ends
> Other flexibilities unrelated to Medicare that will end immediately once the PHE ends:
- HHS Office of Civil Rights’ enforcement discretion relating to telemedicine platforms that are not HIPAA-compliant, and
- The exception to the one-visit prior to prescribing controlled substances under the Ryan Haight Act
EDUCATIONAL VIDEOS (non-CME)
- Telepsychiatry and COVID-19: What We Do and Do Not Know (6/20, 48 min)
- Let’s Talk! Telepsych Updates (9/22, 37 min) NEW!
RESOURCES
- Telepsychiatry Checklist (updated 7/22)
- Five Things to Know About the Ryan Haight Act (7/21)
- Preparing For What's Next - To Do List (updated 7/21)
- Seeing Patients in Your Office (8/21)
- Telepsychiatry: Keeping Up With Your Regulators' Waivers (2/21)
- Prescribing Controlled Substances and HIPAA Impact Chart
COVID-RELATED STATE LICENSURE WAIVERS
TEXTBOOKS WITH CHAPTERS WRITTEN BY PRMS RISK MANAGERS:
- Mental Health Practice in a Digital World: A Clinicians Guide, 2015, edited by Dewan et al
Chapter 8: An Overview of Practicing High Quality Telepsychiatry (Vanderpool)
Publisher: Springer, https://www.springer.com, 212 460 1500
ISBN 978-3-319-14109-1
- Psychoanalysis Online 2: Impact of Technology on Development, Training, and Therapy, 2015, edited by Scharff
Chapter 8: Legal Aspects of Teleanalyisis in the United States (Vanderpool)
Publisher: Karnac, https://www.karnacbooks.com/
ISBN 978-1-78220-321-6
- Malpractice and Liability in Psychiatry, 2022, edited by Ash et al
Chapter 4. Professional Liability Insurance (Vanderpool)
Chapter 6. Do’s and Don’ts After an Adverse Event (Cash)
Publisher: Springer, https://www.springer.com, 212 460 1500
ISBN 978-3-030-91974-0
- The American Psychiatric Association Publishing Textbook of Suicide Risk Assessment and Management, Third Edition, 2020, edited by Gold and Frierson
Chapter 27. Suicide Risk Management: Mitigating Professional Liability (Vanderpool)
Publisher: APPI, https://www.appi.org, 800-368-5777
ISBN 978-1-61537-223-2
- The American Psychiatric Association Publishing Textbook of Forensic Psychiatry, Third Edition, 2018, edited by Gold and Frierson
Chapter 12. Professional Liability in Psychiatric Practice (Vanderpool)
Publisher: APPI, https://www.appi.org, 800-368-5777
ISBN 978-1-61537-067-2
- Gun Violence and Mental Illness, 2015, edited by Gold and Simon
Chapter 13: Relief from Disabilities: Firearm Rights Restoration for Persons Under Mental Health Prohibitions (Vanderpool and Gold)
Publisher: APPI, https://www.appi.org, 800-368-5777
ISBN 978-1-58562-498-0
- Oxford Textbook of Correctional Psychiatry, 2015, edited by Trestman et al
Chapter 61: Forensic Issues (Vanderpool and Roskes)
Publisher: Oxford University Press, http://oxfordmedicine.com/, 800-624-0153
ISBN 978-0-19936-057-4
- Clinical Guide to Mental Disability Evaluations, 2013, edited by Gold and Vanderpool
Chapter 2: Legal and Ethical Issues in Providing Mental Health Disability Evaluations (Vanderpool)
Publisher: Springer, https://www.springer.com, 212 460 1500
ISBN 978-1-4614-5447-2
- Ethical Issues in Forensic Psychiatry: Minimizing Harm, 2011, edited by Sadoff
Chapter 13: Risks of Harm to the Forensic Expert: The Legal Perspective (Vanderpool)
Publisher: Wiley, https://www.wiley.com
ISBN 978-0-470-67013-2
COVERAGE FOR TELEPSYCHIATRY
Our psychiatric professional liability policy includes nationwide coverage for telepsychiatry at no additional cost.
CONTACT US TO LEARN MORE!
(800) 245-3333
TheProgram@PRMS.com