Document Type

Article

Publication Date

Fall 2021

Abstract

This Article examines the dramatic expansion of telehealth during the COVID-19 public health emergency and argues that the pandemic created a unique regulatory laboratory for evaluating longstanding legal and economic barriers to telehealth adoption. Prior to COVID-19, telehealth growth was constrained by a complex web of state licensure requirements, physician–patient relationship rules, federal prescribing restrictions (including the Ryan Haight Act), Medicare geographic and originating-site limitations, and inadequate reimbursement structures. In response to the pandemic, federal and state governments issued sweeping waivers that relaxed privacy enforcement, expanded reimbursement, eased prescribing limitations, and temporarily dismantled geographic and site-of-service constraints.

Drawing on the experience and data generated during this period of regulatory flexibility, the Article contends that policymakers should neither fully revert to the pre-pandemic framework nor permanently codify all emergency waivers. Instead, legislators and regulators should recalibrate telehealth regulation to preserve patient safety, combat fraud and abuse, and ensure data security, while eliminating unnecessary geographic, licensure, and reimbursement barriers that impede access and innovation. The Article ultimately proposes a more coordinated, efficiency-oriented regulatory structure designed to promote sustainable, high-quality telehealth delivery in a post-pandemic healthcare landscape.

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