The Cost of Lost Telehealth Care in Pennsylvania

As the country marks national Telehealth Awareness Week, a new investigation reveals that Pennsylvanians are losing access to remote health services. Initial findings of a study conducted by Americans for Prosperity Foundation (AFPF) show that patients have lost access to thousands of health care providers from other states offering telehealth services to Pennsylvanians.

In early 2020, patients sick from the first wave of COVID-19 were flooding Pennsylvania’s health systems. To ramp up services, on March 18, 2020, Gov. Tom Wolf authorized health care practitioners licensed in other states to provide telehealth services to Pennsylvanians without obtaining a Pennsylvania license. Out-of-state practitioners were required to be in good standing in their state of practice and submit their licensure information to the appropriate Pennsylvania health-licensing board.

This new flexibility greatly expanded access to health care, but last summer, the Pennsylvania Department of State began phasing it out. The out-of-state waivers officially expired on June 30, 2022.

For over two years, Pennsylvanians had enjoyed expanded health care access, establishing intimate patient-provider relationships with out-of-state health care practitioners via telemedicine. These patients no longer have access to their providers.

Just how much telehealth care did Pennsylvanians lose?

The Pennsylvania chapter of AFPF filed a Right to Know Law request with the Pennsylvania Department of State seeking records on the out-of-state healthcare providers who received emergency waivers to provide telehealth services to patients in the Keystone State.

So far, we have received records from several health licensing boards. After reviewing the documents, AFPF estimates that approximately 900 speech-language pathologists and 650 occupational therapists from other states sought to treat Pennsylvanians during the public health emergency. The only reason they cannot continue to treat patients and clients is because of outdated state licensing requirements, which are keeping out-of-state practitioners from working with patients in Pennsylvania.

Encouragingly, however, the shortage of health care providers is spurring the state to review some of these bureaucratic rules. In July 2021, the Pennsylvania General Assembly had passed the Nurse Licensure Compact Act, making Pennsylvania a party to the Nurse Licensure Compact, an agreement between 41 states and territories that allows nurses licensed through the compact to practice medicine in any member state. It’s unclear why Gov. Josh Shapiro or his predecessor have failed to implement the NLC Act until now, more than two years after the bill became law. But earlier this month, registered nurses from other states holding multistate licenses through the NCL became eligible to provide in-person care and telehealth services to Pennsylvanians.

Pennsylvania’s nursing shortage persists. The Hospital and Healthsystem Association of Pennsylvania published a survey in January 2023 showing a vacancy rate for RNs of 30.7%, a 10% increase since pre-pandemic levels in 2019.

Implementing the NLC Act should help alleviate nursing shortages and provide patients in Pennsylvania with more options and greater access to care. But Pennsylvania’s health care shortages extend beyond nursing. The Keystone State has 15 health licensing boards, covering dentistry, medicine, nursing, pharmacy, psychology, and more. We need to expand access to telehealth for all practitioners.

The AFPF’s investigation is ongoing. We look forward to receiving the lists of health care providers granted emergency telehealth waivers from the remaining ten health licensing boards and providing Pennsylvanians with a complete picture of the expanded access to health care they unnecessarily lost a year ago.