Which Pandemic Prompted Telehealth Waivers Are Still in Effect? With Dr Edward Kaftarian

Telehealth waivers implemented in response to the COVID-19 pandemic may no longer be in effect, and clinicians should take steps to stay informed, says Psych Congress Steering Committee Member and CEO of Orbit Health Telepsychiatry, California, Edward Kaftarian, MD. This podcast insights clip recorded onsite at Psych Congress 2022 in New Orleans, Louisiana, explores the key waivers implemented by states and the federal government, and where to state up to date with their current status.

Dr Kaftarian presented "Telehealth Rules and Regulations: A Post-Pandemic Update" at Psych Congress. Be sure to reserve your spot now for Psych Congress 2023 and join us in Nashville, Tennessee, next September! For more news and insights from this year's conference, visit the newsroom.

Edward Kaftarian, MD, is chairman and CEO of Orbit Health Telepsychiatry. Dr Kaftarian is a nationally recognized psychiatrist and leader in the field of telepsychiatry and healthcare technology. Trained at the world-renowned Johns Hopkins Hospital, he is board-certified in psychiatry, forensic psychiatry and addiction medicine. Dr Kaftarian has served in a variety of executive roles within the California prison system, including chief psychiatrist, senior psychiatrist, medical director, and director of pharmacy. He is the founder of California’s Statewide Prison Telepsychiatry Program, which is the largest correctional telepsychiatry program in the world.

Read the transcript:

Dr Edward Kaftarian: Hi, my name is Dr Edward Kaftarian. I'm a psychiatrist and CEO of Orbit Health Telepsychiatry. I'm here to talk to you about waivers that were implemented because of the COVID-19 pandemic.

One of the types of waivers that was commonly implemented was a waiver of licensure, meaning if I have a license in one state, but not in the state where the patient is located, in some states, I was able to practice medicine. For example, I was able to practice medicine in the state of Hawaii using my California license, and that is what I did for a while.

But, I also want to tell you that a lot of these waivers have been canceled.

For example, Hawaii no longer recognizes California and [a number of] other states. Now, in order to practice medicine in Hawaii, I need a Hawaii license.

Over the last year, from about May 2021 to May 2022, a lot of the waivers have been canceled.

The way that you can find out what waivers are still in effect is by going into the Federation of State Medical Board website, and you can find a list of the current waivers. It went from 47 states to about 14 states, and it's probably less by now.

The continuing medical education (CME) waiver was another waiver that was implemented during the pandemic. Some states were forgiving doctors for not being up to date on their CME requirements because, during the pandemic, it was hard to go in person to wonderful conferences like Psych Congress and Elevate by Psych Congress. Those conferences were virtual, and a lot of people were able to attend virtually, but some were not. Some states recognized that it was hard to stay current on your CME when there is a pandemic.

A lot of those waivers have been retracted. As clinicians, you need to check the board website for each of your state medical boards that you want to practice medicine in, and you can find out what kind of waivers are still in effect.

The third topic that I wanted to talk to you about regarding waivers was the Ryan Haight Controlled Substances Act. The Ryan Haight Act really limits the ability to prescribe controlled substances unless you do an in-person visit. There were 7 exceptions that applied to telehealth, one of which was if there is a public health emergency declared by HHS. This pandemic met the criteria for that exception, and therefore, psychiatrists and other providers have been prescribing controlled substances with telehealth appointments.

Now, we don't know what's going to happen once this pandemic is over. The DEA is supposed to put together a special registration process for telehealth.

What I'd do, is I would monitor that situation. I would look at the DEA websites. I would look at Psych Congress websites, which will probably have some updates. That way, you can stay informed about the waiver of the Ryan Haight Act.

Those are some of the waivers that were involved in the COVID-19 pandemic.