By Geoffrey Boyce, Originally published on American Journal of Managed Care
New Policies Expand the Reach of Telepsychiatry for Opioid Use Disorder
Telepsychiatry has the potential to help address one of the nation’s most significant crises: opioid use disorder. However, policy changes are needed first. In 2019, the Drug Enforcement Administration (DEA) is expected to establish special registration for telemedicine, as required by the SUPPORT for Patients and Communities Act of 2018.
The prescribing of controlled substances is necessary for a common treatment of opioid use disorder: medication assisted treatment (MAT). However, current federal regulation—the Ryan Haight Online Pharmacy Consumer Protection Act of 2008—limits the prescribing of controlled substances via telemedicine. By creating the long-awaited special registration for telemedicine in 2019, the DEA will help open doors for the appropriate prescribing of controlled substances via telemedicine, and thus allow for telepsychiatry to help address the opioid epidemic.
Additionally, another impactful way the special registration for telemedicine would improve access to needed care is with child and adolescent psychiatry—a discipline where certain controlled substances are the preferred treatment for common disorders such as attention deficit/hyperactivity disorder.
New Policies Expand the Reach of Telepsychiatry for Medicare Populations
Another exciting policy development for telemental health is the Mental Health Telemedicine Expansion Act that was introduced this year, which, if enacted in 2019, would have a significant impact on America’s aging population. The bill would eliminate the originating site requirement for Medicare reimbursement for telemental health services. Currently, there are 8 originating site requirements for Medicare reimbursement, including provider offices, hospitals, critical access hospitals, rural health clinics, federally qualified health centers, skilled nursing facilities, community mental health centers, and hospital-based or critical access hospital-based renal dialysis centers. By eliminating this requirement, Medicare beneficiaries would be able to be reimbursed for telemental health services they receive in their home and other settings.
Growth of Telepsychiatry in Collaborative Care Models
In recent years, the use of team-based approaches like the IMPACT model have proven successful for a wide range of behavioral health conditions. Telepsychiatry helps advance the use of these models by removing the need for care teams to colocate. Providers can conveniently interact and seamlessly deliver care via televideo.
Payers are particularly invested in the expanded use of collaborative care models and are increasingly looking for creative ways to partner with telepsychiatry providers or practices leveraging telepsychiatry to achieve the greatest value in care. With the recent addition of collaborative care codes for reimbursement, providers will also be encouraged to incorporate more team-based treatments into care.
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