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The Department of Health and Human Services says that federal waivers can only go so far, and calls on states to quickly act to relax licensure, telehealth, and other requirements that may impede an effective response to the COVID-19 pandemic.

The Department of Health and Human Services says that federal waivers can only go so far, and calls on states to quickly act to relax licensure, telehealth, and other requirements that may impede an effective response to the COVID-19 pandemic.

The U.S. Department of Health and Human Services is calling on states to take "immediate actions" to relax laws and regulations that HHS thinks could get in the way of effective health care responses to the COVID-19 pandemic. The recommended actions include licensure exemptions and disciplinary moratoriums, waiver of telemedicine practice prohibitions, relaxation of scope-of-practice requirements, and easing of malpractice liability.

In a March 24 letter to U.S. state governors, HHS Secretary Alexander Azar wrote that the requests are being made "to carry outa whole-America response to the COVID-19 pandemic," adding that "your help is needed to ensure health professionals maximize their scopes of practice and are able to travel across state lines or provide telemedicine to their communities or where they are needed most."

While the federal government has initiated modifications of some Medicare, Medicaid, and CHiP requirements under so-called 1135 waivers, HHS explains that those exceptions only go so far: states still hold the cards when it comes to much of what providers can and can't do as part of the response to the pandemic. That's why HHS is urging states to take action.

Among the HHS recommendations:

Exceptions to various licensure requirements. HHS is calling on states to, among other actions, waive licensing fees, allow for free temporary licenses, and suspend disciplinary actions for certain licensure violations that prevent licensed providers from providing treatment.

Telemedicine provisions. States should "waive statutes and regulations mandating telehealth modalities and/or practice standards not necessary for the application standard of care to establish a patient-provider relationship, diagnose, and deliver treatment recommendations utilizing telehealth technologies."

Scope-of-practice waivers. HHS calls for easing scope-of-practice restrictions around supervision, collaboration, and disciplinary enforcement.

Malpractice liability assistance. States should "provide guidance on liability protections available to health care professionals" that include :volunteers, services provided through telehealth, and services associated with expanded scopes of practice" during the emergency, according to HHS, which recommends that states work with state insurance commissioners to "modify or temporarily rescind any provision … issued in our state that may prevent insurance coverage of a health care professional's work."

"I do not want state variations in liability protections to confuse or deter health professionals in this COVID-19 emergency," Azar writes. "I also ask that you take quick action to expand the flexibilities offered in this time of emergency by waiving restrictions such as state licensure, scope of practice, certification and recertification requirements."


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