Reversal of telehealth policies would send Georgia back – SaportaReport – SaportaReport

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In early January 2024, the Georgia Composite Medical Board hastily announced virtual prescribing restrictions, returning telehealth to the pre-pandemic era rules. Within 72 hours, however, the Board reversed its decision.

Why? Because healthcare providers in the state, particularly psychiatrists, understand the critical need for solutions like telehealth and evidence-based technology to reduce barriers to care. ADHD patients specifically stand to lose the most from restricted telehealth access, especially after grappling with a medication shortage since October 2022.

It’s imperative we take steps forward, rather than steps back, to better serve ADHD and all mental health patients in Georgia.

How restrictions put pressure on patients, providers and the state

Ctel, a legal and regulatory telehealth organization, conducted its Telehealth Cost Impact Survey, revealing that 30 percent of patients seek mental and behavioral health services through telehealth platforms. Knowing that 90 Georgia counties lack a psychiatrist, and many rural areas are experiencing a provider and nurse shortage, proves how critical telehealth is for patients in those areas. Without this method of care, they will continue to be at a disadvantage if telehealth access is restricted.

Coverage from the Atlanta Journal-Constitution cites that even large health systems in the city were struggling with the Board’s initial ruling, working over the holidays to try and assist patients in getting the necessary appointments and documentation for their medication. But that just isn’t feasible for every patient, like those with ADHD.

ADHD patients suffer from a range of symptoms, and they all present differently in every patient. But by and large, the impact on executive functioning makes it difficult for many patients to keep track of even simple tasks — like doctors’ appointments and prescriptions.

“There is an evident need to focus on better education around ADHD,” said Melinda Williams-Willingham, a Snellville, Ga.-based pediatrician. “Many practitioners lack robust training for ADHD, and there is no current standardization of care for adults with ADHD. ADHD patients also often suffer from comorbid conditions, which can increase negative outcomes — academically, socially and professionally. There are already many barriers to care for ADHD patients, and new challenges at the state level can impede that further.”

The Georgia Composite Medical Board ruling also came long before the Federal Government’s reassessment of telehealth policies. The current nationwide ruling on telehealth prescribing is up for review in December 2024, meaning the Board’s ruling came almost a full calendar year before any Federal review or policy revisions. Even with the reversal, the Georgia Board states it will reassess the decision in May 2024. With state-level decisions coming in such advance of those at the Federal level, it makes the state appear far less progressive on mental health issues.

Standardization for Better Care

The recent rulings in Georgia show that the Georgia Composite Medical Board — and possibly other states in the coming future — are using broad strokes to restrict telehealth rather than thinking through effective solutions to better serve ADHD and mental health patients. There must be a call for collaboration between boards, healthcare and telehealth providers, and government to develop effective, long-term plans.

The government has taken some steps to determine the best course of action, with the Drug Enforcement Administration (DEA) listening sessions last fall, in which more than 38,000 public comments were submitted expressing concern over telehealth limitations. This led the DEA to its current decision to revisit prescribing policies at the end of this year. 

The ADHD Expert Consortium is one independent group already calling for action for ADHD patients, with their consensus statement outlining the need for standardizing ADHD care and management. The incorporation of evidence-based, objective ADHD testing would help streamline the process, allowing clinicians to be more confident in their diagnoses and reducing the risk of over or under-prescribing. This could help eliminate concerns over the prescribing of stimulants to treat ADHD.

With solutions available to bolster telehealth care and improve clinician confidence, we can create an equitable system that does not undermine the progress we’ve made.