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APA initially wrote a letter to CMS on March 20, requesting that the agency waive the requirement that telemedicine for patients with mental and substance use diagnoses include a video component when that option is not available. In the letter sent today, APA expressed the urgency of the situation for APA members and their patients.
“APA has been receiving a high volume of calls from our psychiatric members indicating that further action is needed,” the letter states. Some Medicare beneficiaries do not have the internet access necessary for videoconferencing or they have older phones without a camera; others are unfamiliar or fearful of technology, the letter states.
“APA therefore … requests that all telehealth psychiatric services be considered as complete encounters when conducted by psychiatrists using the telephone only, at the same rate as an in-person visit,” the letter continues. “This is gravely needed during this public health crisis where social distancing is a necessity and even the most healthy have increased anxiety at the prospect of leaving home to seek treatment.”
“Even if we can’t physically see our patients, we can provide medication management and psychotherapy,” said APA President Bruce Schwartz, M.D., in a news release about the letter. “We must be able to provide care to our patients in a way that respects current guidelines on social distancing. Now is the time for CMS to revise the rule so that all people with serious mental illness and substance use disorders can access the vital care they need.”
The letter expressed appreciation for the work CMS has done so far to ensure access to psychiatric services during the coronavirus (COVID-19) crisis and reiterated that APA’s position is that the “gold standard” for telemedicine includes video. “However, these are extraordinary times,” the letter states.
One APA member quoted in the letter said audio should be accepted as the equivalent of telehealth. “The individuals who have audio-only access tend to be the oldest and poorest of the population and need access to services,” the member said. “The comparison is not with the ideal; the comparison is with no service at all which is unacceptable.”
“Our recommendation will ensure that those patients who still rely on older technology can access vital psychiatric services,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in the news release.
Join Physician Call on COVID-19 Tomorrow
AMA invites APA members to participate in a physician call tomorrow, Friday, April 3, from 12:30 p.m. to 2 p.m. This call is part of the series “Lessons From the Front Lines: COVID-19.” The topic of tomorrow’s call will be on COVID-19 flexibilities. Conference lines are limited, so physicians are encouraged to join via audio webcast on a computer or smartphone web browser.