The coming end of the COVID-19 public health emergency and pandemic-era telehealth flexibilities could rattle an already besieged behavioral health system and force providers to make ethical decisions.
The public health emergency, which President Biden will end May 11, allowed clinicians to prescribe controlled substance medications via telehealth without an office visit. The 2008 Ryan Haight Act, which temporarily waived the office visit requirement, allowed providers to treat a larger population of behavioral health patients more efficiently because they could prescribe and see patients remotely.
Unlike other pandemic-era telehealth flexibilities, the rules around the prescription of controlled substances are still tied to the May 11 date.
“We estimate that we will not be able to see new patients for six to nine months as we catch up with having to see patients who we've never seen face to face,” said Dr. Joel Young, medical director of the Rochester Center for Behavioral Medicine in Rochester, Michigan. “This is going to be devastating and the cost will be significant, particularly for adolescent mental health.”
Young said his outpatient behavioral clinic was able to expand its patient base beyond Rochester into more rural areas because of telehealth. The technology and relaxed rules also allowed clinicians to work more flexible hours without the need to see someone in person, which will go away without those flexibilities.
“I feel like we’re going to lose 20% of our workforce who can’t go into an office,” Young said. “Whatever progress we’ve made moving into underserved areas will be reversed overnight.”
The end of the flexibilities will affect patients beyond behavioral health, said Jeremy Sherer, digital health co-chair at law firm Hooper, Lundy & Bookman, who represents providers and telehealth companies. He said it would also affect people undergoing obesity and hormonal treatments, as well as those getting treated for opioid use disorder.
“It’s going to leave a lot of folks in limbo,” Sherer said. “This has become quite widespread.”