APA has gained major expansions in coverage of psychological telehealth services over the past several months. To continue expanding access to telehealth services for the millions of Americans covered by the Employee Retirement and Income Security Act (ERISA) self-insured health plans, APA led major mental health organizations including Mental Health America, the National Association of Social Workers, the National Alliance on Mental Illness, and the American Psychiatric Association in writing to Secretary of Labor Eugene Scalia, urging the Department of Labor (DOL) to issue telehealth recommendations to these health plans. The letter advocates for private-sector plans to adopt the full array of telehealth coverage policies that have been extended to Medicare beneficiaries, and to sustain this coverage for at least 12 months after the end of the COVID-19 public health emergency. The letter (PDF, 254KB) emphasized the importance of covering audio-only provisions for mental and behavioral health services, and asked for the opportunity to meet with DOL staff to discuss options for promoting telehealth coverage.
Many states have laws in place requiring commercial health plans and state Medicaid programs to cover telehealth services, and the Centers for Medicare and Medicaid Services has greatly expanded telehealth services coverage within Medicare during the public health emergency. However, state policy changes do not affect the majority of Americans with self-insured group health insurance, sponsored by their employers, (in which the person’s employer, not an insurance company, is responsible for paying most health bills). These self-insured plans are governed by ERISA, and largely fall under the jurisdiction of the DOL. While some of these plans have established broad coverage policies for telehealth services, and in many cases did so before the COVID-19 pandemic began, others have either adopted only limited coverage expansions or have indicated that expansions will last only until the public health emergency ends.
For more information, contact Alan Nessman or Laurel Stine.
