State Expansion of Telehealth and Licensing Waivers
The Alliance has compiled a resource detailing state-by-state expansion of telehealth and licensing waivers during the COVID-19 pandemic. This document is updated regularly.
CMS Approved 1135 Waivers
Under a disaster or emergency declaration and a public health emergency, the HHS Secretary is authorized to take additional actions to provide programmatic flexibility in Medicare, Medicaid and the Children’s Health Insurance Program through section 1135 waivers. The Secretary may issue blanket waivers, or may approve state specific waivers. Waivers end no later than the termination of the emergency period. CMS recently released a checklist for states to aid in the development of 1135 waivers requests.
Several states have requested flexibility to incent greater use of telehealth through Medicaid Section 1135 Waivers, for example:
- IL, LA, NC, and WA requested CMS to allow providers to use non-HIPAA compliant telehealth modes from platforms like Facetime, WhatsApp, and Skype to facilitate visits
- CA requested flexibility to make it easier for providers to care for people in their own homes by allowing telehealth and virtual/telephonic communications for covered State plan benefits, a Waiver of face-to-face encounters for FQHCs and Rural Health Clinics, and Reimbursement of virtual communication and e-consults for certain providers
- MD requested flexibility so that Medicaid and Managed care enrollees could use telephones to receive care if they did not have an appropriate device.
- SD requested flexibility to allow Medicaid to pay for the same telehealth services that Medicare has been granted authority to pay for, including services furnished while a patient is at home.