End of Public Health Emergency: What does it mean for Psychologists in Kentucky?

Karen Graves, Ph.D. - Director of Professional Affairs

There has been a lot going on in KPA in terms of advocacy and legislation, with priorities aimed at reducing suicide rates and improving access to care. More to come in an April Town Hall meeting about outcomes of this year’s legislative session and how they may impact you and your clients. For today’s newsletter I’ll briefly focus on the upcoming end of PHE and its impact on psychologists.

As many of you have heard, due to a reduction in COVID-19 patterns of infections, the Department of Health and Human Services has started to make plans for the end of the federal Public Health Emergency for COVID-19 (PHE). The slated date, as of this writing for Federal PHE to end is at the end of the day on May 11, 2023. (You may also remember that the legislature in Kentucky ended the state of emergency related to COVID-19 on March 21, 2022.)  PHE, which included temporary modifications from the Centers for Medicare & Medicaid Services (CMS), allowed for changes to many aspects of health care delivery during the COVID-19. The goal of regulators and agencies involved in these adjustments were aimed at allowing health care providers maximum flexibility in service delivery while improving access to care during the COVID-19 emergency. 

Currently it appears that some of the changes that had been put in place will be permanent or at least extended while others will expire completely. Below is a summary of the changes that will have most impact on Kentucky psychologists. For more detailed information please take a look at: https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf

An even more extensive summary of changes can be found at: https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html

Access to Telehealth Services:

Many of the telehealth flexibilities offered through PHE have been extended through December 31, 2024:

  • People with Medicare can access telehealth services regardless of their geographic location, rather than only those in rural areas. 
  • Medicare will continue to reimburse for telehealth services. Those with Medicare can remain home for telehealth visits rather than traveling to a health care facility. 
  • Certain telehealth visits can be delivered audio-only (such as a telephone) if someone is unable to use both audio and video, such as a smartphone or computer.   

Medicaid, CHIP, and Telehealth

Telehealth flexibilities for those with Medicaid and CHIP are not tied to the end of the PHE. Kentucky has passed legislation (HB140) to allow continued telehealth services for Medicaid recipients.  See this document for more details. Of importance to psychologists who are Medicaid providers is the announcement that providers will need to come into compliance with the revalidation requirement once the PHE ends. ACT NOW if you want to maintain your status as a Medicaid provider.   

Private Health Insurance and Telehealth

As is currently the case during the PHE, coverage for telehealth and other remote care services will vary by private insurance plan after the end of the PHE. Keep in mind that each insurance company may have their own guidelines regarding cost-sharing, prior authorization, or other forms of medical management on telehealth and other remote care services. Those of you who accept insurance are aware of these variations and are encouraged to contact the insurer’s customer service for more information. 

Virtual Supervision 

To allow more people to receive care during the PHE, CMS temporarily changed the definition of “direct supervision” to allow the supervising health care professional to be immediately available through virtual presence using real-time audio/video technology instead of requiring their physical presence. CMS also clarified that the temporary exception to allow immediate availability for direct supervision through virtual presence also facilitates the provision of telehealth services by clinical staff “incident to” the professional services of physicians and other practitioners. This flexibility will expire on December 31, 2023. Watch for ongoing updates regarding this flexibility throughout 2023.