Hundreds of psychotherapists and wellness service providers are asking Gov. Ned Lamont to remove barriers to teletherapy for those who have private insurance and allow phone therapy sessions for the elderly during the coronavirus pandemic.
The state Department of Social Services expanded options for telemedicine for those who are on state-run insurance plans such as the HUSKY insurance plan. Lamont by executive order Wednesday expanded Medicaid telehealth coverage to include audio-only telephone.
But more than 700 mental health and wellness providers told Lamont in a letter Monday that their patients are having difficulty accessing coverage for teletherapy sessions with private insurance companies which are refusing to pay or limiting coverage in some cases.
“I have people who are suffering from anxiety who are having increased anxiety because of the situation,” said Jorge Fernandez, a therapist who is the sole proprietor of Nuevo Dia Family Wellness, LLC, in Hamden. “This is very real. There’s going to be an increase in depression, there’s going to be an increase in suicidal thoughts.”
Lamont has issued several executive orders in an attempt to delay the spread of the COVID-19 virus including prohibiting large crowds and closing restaurants and bars which now can only offer take-out service. State officials are asking people to stay home and distance themselves from others as much as possible. Many state functions have moved online with state and local government offices closed to the public to prevent the spread of the virus.
Fernandez and Rebecca Burton, a therapist and owner of Beehive Counseling Services in Manchester, drafted the letter to Lamont after noticing that private insurance companies were using what they called a “loophole” that allows self-funded plans to deny coverage for teletherapy.
However, what the therapists may see as a loophole is actually a reflection of federal law that allows self-funded plans to set the benefits that they will cover within parameters set by the federal government, Susan Halpin, executive director of the Connecticut Association of Health Plans explained. Insurers can recommend that certain benefits like teleheath be covered but it’s ultimately up to the employer to approve the coverage. Almost 65% of Connecticut’s market is under these self-insured plans.
“We’re having to call each and every client to have them find out if they are covered for teletherapy,” Burton said. “We have some clients who are struggling who can’t access teletherapy treatment. We’re also afraid for ourselves.”
Within six hours of Burton and Fernandez posting the letter to a Facebook group of wellness professionals, more than 700 other service providers signed on, the pair said.
They are seeking an executive order lifting any insurance restrictions that would bar people from accessing teletherapy. The groups also wants Lamont to ease a state law that deems phone therapy sessions as not compliant with HIPAA and privacy requirements. Lamont may not have the ability to do that for plans that are regulated by the federal government.
“People who can’t access telehealth are usually in a few categories,” Burton said. “They are either economically disadvantaged and don’t have access to technology or the Internet, or they are elderly or disabled and have a lot of difficulty using technology.”
Those are the types of people who at most risk for complications or death if they contract the virus, she said.
If therapists could use cell phones or landlines to speak to people for remote sessions, it would open up channels for therapy that wouldn’t require face-to-face meetings or technology, she said.
“Using a phone is not the preferred way, but I think we have to do what we have to do in these circumstances,” Burton said.
Fernandez has been working with clients to set up the technology to conduct teletherapy sessions only to have it fail, he said. “The barriers to technology are real,” Fernandez said. “And whether or not your insurance company will cover teleservices is also real.”
The federal government issued vague guidelines about using HIPAA-compliant platforms Tuesday, but Fernandez said Connecticut providers are waiting for direction from the state.
“We need the governor to take action,” he said. “Doing sessions by phone is not ideal but it would keep people connected with their therapists, who in some cases are their only contact in this isolation, but it would also keep our businesses intact.”