Connecticut Allows New Telehealth Capabilities and Further Expands Clinical Workforce in Response to COVID-19 Pandemic

On April 22, 2020, Governor Lamont issued Executive Order No. 7DD that expands the ability of health care providers to offer services remotely. This Executive Order also expands the health care workforce in Connecticut in several ways.

Remote Services

Changes to the laws governing telehealth services include the following:

• The definition of “telehealth provider” in Connecticut General Statutes 19a-906(a)(12) is revised to include properly licensed dentists, behavior analysts, genetic counselors, music therapists, art therapists and veterinarians.
• The Order expands on the provisions of Executive Order No. 7G regarding the ability of in-network providers for commercial fully insured health insurance to provide telehealth services through the use of audio-only telephone (see our prior Alert for a discussion of EO 7G), by allowing these providers to perform telehealth services to patients even though there is no existing provider-patient relationship. NOTE: Executive Order No. 7FF, issued on April 24, 2020, permits telehealth providers who are Medicaid-enrolled providers providing covered telehealth services to “new or established patients” who are Medicaid recipients to engage in telehealth through the use of audio-only telephone. (Note that the federal Centers for Medicare and Medicaid Services has stated that the Department of Health and Human Services will not conduct audits to ensure that a prior relationship existed for claims submitted during this public health emergency.)

These changes preceded the release yesterday by CMS of a State Medicaid and CHIP Telehealth Toolkit to help states accelerate adoption of broader telehealth coverage policies in the Medicaid and Children’s Health Insurance Programs during the pandemic.

Expansion of Health Care Workforce

Executive Order 7DD also implements the following modifications related to health care providers:

• Section 19a-131j(a) of the Connecticut General Statutes (CGS) allows the Commissioner of Public Health to issue an order to suspend, for up to 60 days, the requirements for licensure, certification or registration of certain out-ot-state health care providers, including physicians, physician assistants, physical therapists, registered nurses, nurse’s aides and respiratory care practitioners. EO 7DD expands this list to include occupational therapists, alcohol and drug counselors, radiographers, radiologic technologists, radiologist assistants, nuclear medicine technologists, dentists, dental hygienists, behavior analysts, genetic counselors, music therapists, art therapists, dietician-nutritionists and speech and language pathologists.
• EO 7DD modifies the statute (CGS 20-11a) governing intern and resident physician programs and the United States medical officer candidate training program to allow a person to participate in such a program prior to issuance of a permit by the Department of Public Health (DPH) if the hospital administrator documents that the person has satisfied the statutory requirements for the permit.

• Similarly, EO 7DD modifies the statute (CGS 20-12h) governing resident physician assistant programs and allows a person to participate in such a program in a short-term hospital that provides a postgraduate medical education program accredited by the Accreditation Council for Graduate Medical Education, without a license, temporary permit or a training permit, provided that the hospital administrator documents that the person is to be appointed a resident physician assistant in such hospital and has satisfied certain of the licensure requirements of CGS §20-12b.
• Certain supervision requirements for physician assistants (in both hospital and non-hospital settings) are temporarily suspended, including the requirement of a personal review of the PA by the supervising physician and review of the charts and records on a regular basis.
• EO 7DD also suspends, on a temporary basis, the requirement that the physician supervising the prescriptive activity of an advanced practice registered nurse (APRN) certified by the American Association of Nurse Anesthetists who is prescribing and administering medical therapeutics during surgery, be physically present in the setting where the surgery is being performed.

• Connecticut permits respiratory care therapist students and respiratory care technician students to provide services without a license if, among other things, they are enrolled in an educational program and the services are a required component of the student’s course of study; EO 7DD provides that such services need not be part of a course of study.
• The continuing education requirements for a long list of health care providers running from physicians to nursing home administrators have been modified. The requirements are suspended for one year for those professions with annual education requirements and for six months for the other professions. The modifications apply to each person for the continuing education year in which March 10, 2020 lies for him or her.

• Finally, EO 7DD modifies CGS 17a-248 (as well as any associated regulations, rules, and policies) to authorize the Commissioner of the Office of Early Childhood to temporarily expand the definition of “eligible children” to include children who turn older than 36 months who are presently engaged in early intervention services and not already determined to be eligible for services under Part B of the Individuals with Disabilities Education Act. The purpose of this modification is to further supplement access to services during the period of school class cancellations due to the pandemic.

For more information, please contact a Pullman & Comley Health Care attorney.