New York Telehealth Reforms – 2021 and Beyond

The Empire State continues its expansion of telehealth adoption as Governor Andrew Cuomo introduced a number of proposals as part of his 2021 State of the State agenda set to “permanently adopt COVID-19-era innovations” in telehealth.  The proposals are part of a wave of proposed legislation meant to cement the changes in telehealth regulation necessitated by the COVID-19 pandemic (the “Pandemic”). Building on New York State’s adoption of Senate Bill S8416 over the summer which had already made a permanent change in the expanded definition of telehealth to include audio-only telephone communication, if adopted the proposal would provide licensing reciprocity in certain specialties, as well as remove traditional prerequisites to the provision of telehealth.

At the outset of the Pandemic, Governor Cuomo suspended a number of regulations pertaining to telehealth as part of the executive orders he was issuing to respond to the crisis (EO Nos. 202.1, and 202.5). This was an integral part of ensuring that patients still had access to care, without providers having to worry about running afoul of state practicing regulations. Among the suspended regulations were the requirements that: (i) telemedicine providers have a New York license in order to provide telemedical services to patients within the state; (ii) a patient be located within a facility in order to receive reimbursement under Medicaid for certain services; and (iii) a patient first receive an in-person evaluation before receiving telemedical services related to mental health and substance use disorders.

The Governor’s plan includes four categories of proposed reforms:  (i) “Unlocking the Benefits of Telehealth Through Policy Modernization;” (ii) “Ensuring Coverage and Reimbursement for Telehealth;” (iii) “Expanding the Use of Technological Advancements in Health Care;” and (iv) “Supporting Patients and Providers Through Professional Development, Education, and Innovative Support Programs.”

The first category, “Unlocking the Benefits of Telehealth Through Policy Modernization,” includes permanently eliminating the originating site requirement for Medicaid reimbursement, and the in-person evaluation requirement. Notably, the plan does not make permanent the suspension of the requirement that providers have a New York license, instead it calls for “Developing interstate licensing reciprocity with states in the Northeast region for specialties with historical access shortages to ensure that there is sufficient access to medical and behavioral health professionals.”

The latter three categories of the plan also include new proposals meant to incentivize the use of telemedicine beyond the Pandemic. Among these proposals are changes to what must be covered by health insurers providing coverage within the state, the creation of a Telehealth Training program, and the creation of a program meant to make patients more comfortable with the use of telemedicine.

Like in many other states, the agenda signals a strong desire to keep the momentum created by the Pandemic for the adoption of telehealth reform in New York. We will continue to monitor the state legislature and executive actions of Governor Cuomo as his proposals get implemented.