Testimony before the Tennessee Committee on Ways and Means Regarding HB 2561 on Telehealth

Published March 9, 2022

Thank you Chair and committee members for the opportunity to testify today on House Bill 2561. I would like to thanks to Rep Terry for bringing this legislation forward. My name is Matt Dean, and I am a senior policy fellow with the Heartland Institute. The Heartland Institute is a 37-year-old independent, national, nonprofit organization whose mission is to discover, develop and promote free-market solutions to social and economic problems. Heartland is headquartered in Illinois and focuses on providing national, state and local elected officials with reliable and timely research and analysis on important policy issues. 

The audiology and speech pathology licensure compact will allow providers from several states to help patients in Tennessee, while allowing Tennessee providers to reach beyond borders to help people across the country. Tennessee will join the originating fifteen adopter states if this legislation is signed into law. The original states are Alabama, Colorado, Georgia, Kansas, Kentucky, Louisiana, Maryland, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Utah, West Virginia, and Wyoming. Model legislation is also moving forward in several states as the legislative session moves forward.

The compact is written to ensure safety and improve access for patients, while offering a benefit to providers and the state. In a highly competitive economy, these arrangements offer a competitive advantage for potential

In 2020, as nonessential medical procedures were postponed in hopes of slowing the spread of the coronavirus, telehealth (which is also sometimes referred to as telemedicine) was forced to immediately scale up to provide connections between patients and providers who were separated by lockdown orders. After nonemergency visits resumed, many patients justifiably feared coming to hospitals and clinics as the virus raged across America. Protecting frontline emergency workers became the highest priority of policymakers who were given models showing a pandemic rivaling or eclipsing the worst pandemics in US history. Telehealth visits became the alternative to bringing millions of sick and healthy people together. Now, state laws are being considered to replace temporary emergency use of expanded telehealth with state-specific laws tailoring their future use.

TELEHEALTH BEFORE AND AFTER COVID-19

Telehealth is most commonly defined as video and audio telecommunication, but some legislation expands that to telephonic communications as well. Telehealth began in surgical suites and emergency rooms to bring the expertise of specialty physicians to complex surgeries and procedures. Over time, telehealth was expanded to replace some face-to-face primary care visits for the convenience of the patient. Patients in remote areas, or those who lacked the ability to travel could see their doctor or mid-level provider from their home. Through 2019, telehealth grew slowly beyond early adopters.

Then came COVID-19, and telehealth was given a trial by fire. In just a few short months, telehealth services skyrocketed from just 2.8% of all healthcare services, to over 70% of services in the first 90 days of 2020. Federal and state emergency executive orders immediately sidelined restrictions on telehealth. Turf wars between providers, that for over a decade to restrict the growth of telemedicine, were declared over. Suddenly, providers were forced to make it work.

The success of telehealth has been recognized as one of the positive outcomes of the tragedy of the pandemic. Patients enjoyed the convenience of being able to see their doctor from home. Physicians could prioritize face-to-face visits for only those visits that could not be done remotely. It was clearly more convenient for both in many instances.

In 2019, congress made permanent the emergency rules allowing the expansion of telehealth. This gave doctors and patients the flexibility to choose which visits could be remote, greatly expanding the access of patients to care. Now states like Tennessee are taking the next steps to strengthen patient access and preserve safety with common sense legislation around telehealth.

Nothing in this testimony is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, The Heartland Institute’s website provides a great link to many policy resources.

The Heartland Institute can send an expert to your state to testify or brief your caucus; host an event in your state, or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact Heartland’s government relations department, at [email protected] or 312/377-4000.