Regulatory Flexibility – Archive

(05/25/21) Broadened Scope of Practice in Assisted Living Should Continue After Pandemic, Association Argues
The Governor of Massachusetts, Charlie Baker, has lifted several COVID-19 restrictions and announced that the state of emergency would end on June 15, 2021. This announcement has caused much concern among assisted living facilities as the state of emergency permitted the state to waive regulations that define the scope of practice for several health professionals. Since this announcement, the Massachusetts Assisted Living Association has advocated for permanent expansion of the scope of practice for assisted living facility nurses.

(05/04/21) State Lawmakers Mull Out-of-State Nurse Licenses After Pandemic Rollbacks
As COVID-19 cases surged, several states temporarily waived state licensure requirements and allowed out-of-state providers to practice in other states without obtaining licensure in the new state. This action contributed to increasing the supply of Registered Nurses as traveling nurses began to practice in other state COVID-19 hotspots. However, several of the executive orders that allowed regulatory flexibility are set to expire. State lawmakers are exploring strategies to avoid future nursing shortages which include adding states to the Nursing Licensure Compact agreement.

(04/07/21) Relaxed Nurse Scope of Practice Boosts Care Access During COVID-19
With scope of barriers being put on hold, nurse anesthetists have improved access to care during COVID-19, according to a new study conducted by the American Association of Nurse Anesthetists (AANA).

(04/03/21) Virginia Launches New Volunteer Vaccinator Registry to Expand State’s COVID-19 Vaccination Workforce
The Governor of Virginia has recently signed legislation that will assist with expanding the state’s vaccinator workforce. Dentists, dental hygienists, veterinarians, optometrists, and health profession students are now eligible to administer COVID-19 vaccinations. Eligible providers are encouraged to register as a volunteer COVID-19 vaccinator through the Virginia Medical Reserve Corps or the Virginia Volunteer Vaccinator Registry.

(03/19/21) Dialysis Clinics Should Be Able to Vaccinate Their Patients on Site
This opinion piece published in STAT calls for health care providers at kidney dialysis centers to be allowed to provide vaccinations to their patients. Patients needing kidney dialysis are at high risk for severe illness or death from COVID-19 infection.

(03/12/21) Expanding Scope of Practice Amid the COVID-19 Pandemic and Beyond
Pharmacists have largely contributed to COVID-19 testing and vaccination efforts after law makers temporarily expanded scope of practice for these health professionals. Policy experts are advocating for improved reimbursement rates and for scope of practice expansions to continue after the pandemic has ended.

(03/12/21) Expanding Scope of Practice Amid the COVID-19 Pandemic and Beyond
Pharmacists have largely contributed to COVID-19 testing and vaccination efforts after law makers temporarily expanded scope of practice for these health professionals. Policy experts are advocating for improved reimbursement rates and for scope of practice expansions to continue after the pandemic has ended.

(03/09/21)Compliance With COVID-19 Related Cal/OSHA, Other Regulations: CDA Resources Can Help
The California Dental Association (CDA) has developed the Clinical Care Workgroup in efforts to assist dentists with safely returning to practice during the COVID-19 pandemic. Dentists have relied on the CDA Practice Support to clarify practice requirements after the California Department of Industrial Relations sent out a letter to dental practice owners. The Clinical Care Workgroup has since released several resources to help dentists comply with temporary regulations set forth in the DIR letter and the California OSHA COVID-19 Emergency Temporary Standards.

(03/08/21) Now Approved to Administer COVID-19 Vaccine, NC Dentists Eager to Help Fight Pandemic
The North Carolina Dentist Board has approved dentists to administer COVID-19 vaccines in state. Dentists can now be more central to the fighting the COVID-19 pandemic.

(03/06/21) It’s Time to Eliminate Bureaucratic Barriers to Health Care Access
This opinion piece from The Hill discusses the regulatory and policy barriers that exacerbate access to health care issues. As COVID-19 cases surged, many states responded with efforts to build workforce surge capacity and support safer ways for patients to access services. Regulatory and policy changes included expanding scope of practice for some health professions, relaxing state health professional licensing requirements and supporting the provision of telehealth services. This article advocates for regulatory and policy reform that includes continued usage of COVID-19 response strategies as a method to expanding the health workforce and access to care.

(02/25/21) Dental Practice Stability, Vaccine Scope Expansion Head CDA’s Legislative Priorities in 2021
California Dental Association is sponsoring four bills in 2021, including a bill that could require dental and medical plans to support their provider networks during future state emergencies and a bill by Assembly member Jim Wood, DDS, to give dentists permanent authority to administer COVID-19 and flu vaccines.

(02/24/21) Pharmacy Students, Dentists, Other Health Care Providers Can Administer COVID-19 Vaccine in Kansas
Governor Laura Kelly issued an executive order allowing pharmacy students, dentists, paramedics and others in health care professions to administer COVID-19 vaccinations.

(02/17/21) Armed and Ready for the Future: Dental Hygienists and Dentists Administering Vaccines
This opinion piece calls for increased regulatory flexibility to allow dentists and dental hygienists to administer COVID-19 vaccines. In 2009, New York and Massachusetts allowed dentists to administer H1N1 vaccines, and following a similar pattern may allow further access to vaccination.

(02/04/21) Lawmakers Reintroduce COVID-19 Telehealth Licensure Bill
A new bill submitted to the United States House of Representatives and the Senate seeks to allow health care providers to use telehealth to treat patients across state lines both throughout and for 6 months following the end of the COVID-19 pandemic. Current rules have been relaxed in some states during the public health emergency, but barriers due to differences between state and federal licensure requirements remain.

(02/03/21) The Pandemic’s Effect on the Health Care Workforce
A public health expert discusses how occupational licensing impacts the health workforce during COVID-19.

(01/16/21) COVID-19: We Can’t Bounce Back With Only Physicians
This opinion piece published in The Hill covers the importance of keeping in mind health professional regulation for non-physicians, including physician assistants and advanced practice nurses, as a way to bounce back from the COVID-19 pandemic.

(01/04/21) Massachusetts Governor Signs Law Safeguarding Telehealth Coverage
Governor Charlie Baker of Massachusetts has signed a law to make permanent many of the telehealth-related regulations put in place to enable better access to virtual treatment during the COVID-19 pandemic. This new bill will require permanent rate parity on certain health services and an expanded scope of practice for some providers, among other provisions.

(01/04/21) Supporting Health Care Competition in the Era of COVID-19: 3 Legislative Models for States
This post to the Health Affairs blog provides some recommendations on ways for states to target legislation to improve competition and bring down costs in the era of COVID-19. These recommendations include bans on anticompetitive provider contract clauses, implementing certification of public advantage laws, and modifying scope-of-practice laws for providers.

(12/09/20) Waiver of State Licensure Requirements for The Delivery of COVID-19 Countermeasures via Telehealth
This article from The National Law Review covers amendments waiving state licensure requirements when providing Covered Countermeasures for COVID-19 treatment using telehealth services. This is significant in that it helps some providers provide some services that were previously limited due to state laws regarding cross-state practice of medicine using telehealth.

(12/04/20) HHS Expands COVID-19 Telehealth Capabilities in PREP Act Amendment
This article covers a new amendment to the Public Readiness and Emergency Preparedness (PREP) Act from the United States Department of Health and Human Services. This amendment aims to ease the regulatory burdens on health care providers seeking to provide telehealth services to patients across state lines.

(11/30/20) The Future of State Telehealth Policy
The National Governors Association provides a summary of the many types of regulatory flexibilities put in place across the nation at both the state and federal level in response to the COVID-19 pandemic. The paper also provides insight on further considerations for governors on long-term goals in telehealth policy.

(11/16/20) VA Clinicians Can Practice Across State Lines, Interim Rule Affirms
A new ruling from the Department of Veterans Affairs has announced VA clinicians are allowed to practice across state lines, even if their practice conflicts with requirements of the individual states in which they are practicing. This ruling is expected to better prepare the VA health care system for effectively managing surges in COVID-19 cases.

(09/16/20) A Brief History of the Future: Healthcare Amid the Pandemic
Regulatory flexibility, reimbursement expansion, and scope of practice changes are just some of the ways COVID-19 has impacted the health care industry in a legal capacity. This brief from McAfee & Taft highlights much of the notable changes experienced from the initial stages of the pandemic to today.

(09/09/20) Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic
This issue brief released from the Kaiser Family Foundation describes many of the flexibilities and other changes states have implemented to their Medicaid programs in response to the COVID-19 pandemic. Reimbursement changes seeking to increase access and coverage for COVID-19 related visits are common themes.

(09/03/20) Lessons Learned and Insights Gained: A Regulatory Analysis of the Impacts, Challenges, and Responses to COVID-19
This regulatory analysis published in The Online Journal of Issues in Nursing takes a look at many of the regulatory changes in response to the COVID-19 pandemic. As nurses have been at the forefront of the pandemic, nursing regulators across the United States have made many changes rapidly, with review of much of the direction only now being analyzed.

(09/01/20) CMS Proposes Significant Changes to Remote Patient Monitoring Coverage
The Centers for Medicare and Medicaid Services has announced clarifications in rules that enable providers to establish and operate remote patient monitoring programs. The flexibility seen during the COVID-19 pandemic has been restricted.

(08/31/20) How COVID-19 Has Unburdened US Physicians In Some Ways
This podcast, produced by Health Affairs, features a discussion with Christine Sinsky of the American Medical Association about relaxed regulation and expansion of physician capacity due to the COVID-19 pandemic.

08/24/20) COVID-19 Pandemic Sends Many State Licensing Exams on Furlough
The Professional Licensing Report published this article covering some of the state licensing exams impacted by the COVID-19 pandemic. In efforts to reduce in-person numbers, some tests have been furloughed and some moved to alternate formats.

(08/21/20) It’s Time to Permanently Suspend Regulatory Barriers to Telehealth
The use of telehealth technology to deliver quality health care has risen substantially amidst the COVID-19 pandemic. Emergency regulations have enabled access and utilization like never seen before, and many are calling for permanent suspension of regulatory barriers to enable telehealth technology to continue to thrive.

(08/13/20) Treats Act Aims to Expand Use of Telehealth to Treat Substance Use Disorder
This article in the National Law Review covers the introduction of a new bill called the Treats Act with a goal of reducing regulatory barriers health care providers face in writing prescriptions through telehealth services. The bipartisan legislation has entered the committee process and aims to develop a pathway to specifically address controlled substance prescriptions for those with substance use disorders.

(08/05/20) Senators Eye Telehealth Licensure Freedom During COVID-19 Emergency
An article covering a new bipartisan bill proposed by Senators Chris Murphy and Roy Blunt with the purpose of allowing interstate licensure for telehealth treatment. State specific licensure requirements are a major barrier to telehealth expansion.

(08/03/20) Key Questions About Nursing Home Regulation and Oversight in the Wake of COVID-19
An issue brief from the Kaiser Family Foundation investigating the impact of regulation and oversight of nursing homes in response to the COVID-19 pandemic. As reports are becoming available it is evident that the majority of nursing homes met the needs of infection control, however nursing home quality of care has been raised as a significant issue.

(07/28/20) AMA & Other Med Groups Express ‘Dismay’ at Prospect of Waivers Made Permanent
An article covering a recent letter sent by the American Medical Association and signed by over 100 physician groups calling for the Centers for Medicare and Medicaid Services to end the temporary expansion of licensure and scope of practice for non-physician health care providers when the COVID-19 pandemic ends.

(07/23/20) The Pharmacist’s Role in COVID-19 Response Efforts
A blog post published in Health Affairs discussing the actual and potential impact of pharmacists to combat the COVID-19 pandemic, given the scope of practice and licensure flexibility many states have allowed for the public health emergency. The post also covers the opportunities for future changes to improve effectiveness and capacity of pharmacists.

(07/16/20) Expanding Telehealth in a Post-COVID World
An article from the National Law Review covering changes in regulation and expansion to telehealth services expected following the end of the COVID-19 pandemic, based on the changes made to address the pandemic. Historic regulations that worked to limit telehealth services have now been largely replaced with those in favor of telehealth service, and that is likely to remain.

(07/13/20) NY Providers Urge Measures to Sustain Telehealth Access Post-COVID
Health care advocacy organizations in New York are calling for making permanent many of the regulatory changes that have improved access to health care through telehealth visits. They are also requesting more flexibility in which health care providers are allowed to offer telehealth services.

(07/09/20) After the Curve: An Analysis of the Changing Face of Healthcare
A legal analysis of the many changes that have occurred in response to the COVID-19 pandemic, ranging from topics of digital health to changes to providers, from health insurance coverage to regulatory and enforcement changes for health care providers.

(06/29/20) Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic
A blog post discussing scope of practice laws and regulations that have changed how health care providers practice during the COVID-19 pandemic. As the pandemic continues, there is an ongoing question of which regulations should remain beyond the emergency.

(06/22/20) Idaho Gov. Little Signs Executive Order Easing Telehealth Restrictions Permanently
An article describing a new executive order signed by the Governor of Idaho, Brad Little, to make some of the regulatory changes enacted to address the COVID-19 pandemic permanent. The state has seen widespread adoption of telehealth services compared to before the pandemic.

(06/17/20) Senate HELP Committee Weighs the Future of Telehealth
An article covering the debate among members of the Senate Committee on Health, Education, Labor and Pensions on which changes to telehealth should be maintained following the COVID-19 pandemic. Two regulatory changes likely to be maintained include the changes to originating site reimbursement and the expansion of Medicare and Medicaid reimbursement for telehealth visits.

(06/08/20) COVID-19 Reveals the Power of Deregulation
An article from Sally Pipes, president and CEO of the free-market think-tank the Pacific Research Institute for Public Policy, covering some of the emergency regulatory changes made in response to the COVID-19 pandemic.

(06/03/20) FTC Asks CMS to Lift Telehealth Access, Reimbursement Restrictions Permanently
An article discussing a new letter sent from the Federal Trade Commission to the Centers for Medicare and Medicaid Services calling for removing regulatory barriers for both telehealth and increasing the scope of practice of some non-physician practitioners.

(05/26/20) CMS Modifies Rules to Allow for COVID-19 Tests Without Physician Orders, Expanded Telehealth and Enhanced Payments for Hospital Owned Practices
An article describing new waivers that the Centers for Medicare and Medicaid Services have enacted in order to further regulatory flexibility to impact COVID-19 testing, care capacity and the health workforce, and an expansion of telehealth services

(05/26/20) COVID-19: Occupational Licensing During Public Emergencies
This frequently updated page on the National Conference of State Legislatures website describes individual state’s emergency actions related to health care licensure.

(05/19/20) HHS Issues Blanket Waivers for Stark Law – Physician Self-Referral in Response to Pandemic
An article discussing the United States Department of Health and Human Services new announcement of blanket waivers of the Stark Law, which will allow health care providers more ability for self-referral of procedures.

(05/14/20) COVID-19 Telehealth Waivers Won’t Last Forever, But Permanent Regulatory Changes Are Afoot
An article discussing the changes to telehealth regulations from the federal level that are set to expire after the COVID-19 pandemic has passed. Congress may be interested in greater regulatory freedom for telehealth practices based on the widespread rapid adoption of telehealth by health care providers.

(05/14/20) COVID-19 and State Medical Liability Immunity
A blog post advocating for the changes many states have made to regulations to protect the health workforce from medical liability during the unprecedented COVID-19 crisis. The post contains a link to a rating system for the medical liability protections by each state.

(05/13/20) COVID-19 Related State Actions
An updated list from the Public Health Institute Center for Connected Health Policy on regulatory changes to telehealth and telemedicine practices across the United States, with clear descriptions of legal changes and sources linked for each state.

(05/08/20) COVID-19: Bill Seeks To Bring 40,000 Green Card Doctors, Nurses To US
An article describing proposed legislation from a bipartisan group of senators to address the shortage of doctors and nurses and issues with access to health care in the United States. The legislation would provide for up to 40,000 immigrant visas that were unused between 1992 and 2020 to finalize green card applications for foreign nurses and doctors.

(04/25/20) Cuomo Announces Expanded Virus Testing in New York
An article describing an executive order by New York Governor Andrew Cuomo that is allowing all pharmacies in New York State to conduct coronavirus tests. The executive order will also allow all first responders, health care workers and essential employees to be tested even if they do not show symptoms..

(04/17/20) California Resists Push to Lift Limits On Nurse Practitioners During COVID-19 Pandemic
An article discussing the political battle in California regarding the scope of practice of nurse practitioners addressing COVID-19.

(04/17/20) COVID-19 Executive Orders
A collection from the New York State Education Department on regulatory changes for healthcare professionals practicing in New York.

(03/26/20) 50-State Survey: Temporary Medical Licensure Measures in Response to COVID-19
This chart compiled by the Association of American Medical Colleges describes emergency medical licensure measures by states, categorized by in person and telehealth/mental health services.

(03/26/20) Indiana’s Executive Orders That Relate to COVID-19 and the Health Workforce
This webpage on the Bowen Center website summarizes Indiana’s executive orders that relate to COVID-19 and the health workforce.

(03/24/20) States Use Federal Waivers to Expand Health Care Resources to Confront COVID-19
This page on the National Academy for State Health Policy website explains how states have used Medicaid waivers to expand health care capacity during the COVID-19 pandemic.