As the coronavirus pandemic continues its course, the nation's focus remains on protecting the health and well-being of all. Over the past few months, most people have hunkered down at home in efforts to flatten the curve, while health care professionals have been on the front lines risking their lives to treat COVID-19 patients. In light of these sudden lifestyle changes due to the outbreak, mental health awareness has become increasingly important, as many are feeling overwhelmed, anxious and socially isolated.

While mental health issues have not always been at the forefront of public health and safety concerns, COVID-19 has shed light on the necessity of adequate access to care for mental and behavioral health services. Historically, patients seeking care for mental health illnesses have faced barriers in terms of obtaining proper health insurance coverage as well as the limited number of healthcare professionals rendering these sorts of services.

Amidst the coronavirus pandemic, state and federal governments have started embracing the notion of utilizing telehealth platforms in place of in-person office visits, which in turn has increased access to behavioral health services. Recently, the federal government's Center for Medicare and Medicare Services expanded telehealth coverage for behavioral health services and waived copayments for individuals with Medicare and Medicaid plans. Health insurance carriers that provide individual and group health coverage have also expanded telehealth coverage for behavioral health services during the COVID-19 response.

With the influx of patients seeking mental health services, state governments have temporarily modified laws surrounding the practice of telehealth by loosening licensure and portability requirements to increase access to virtual care. Since physicians do not have interstate licensure reciprocity, these temporary modifications permit physician practice across state lines. Prior to the outbreak, certain states, like Florida, already permitted healthcare professionals that are licensed out-of-state to provide telehealth services so long as the provider registers with the appropriate board and provides healthcare services within the applicable scope of practice.

In line with the trend of temporarily relaxing legal requirements during the nationwide public health emergency, the Department of Health and Human Services temporarily relaxed the regulations under the Health Insurance Portability and Accountability Act (HIPAA). The modified HIPAA privacy rules permit physicians to communicate with patients on various video-conferencing platforms including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom and Skype. While physicians and hospital systems are relying on the eased rules surrounding telehealth, patient's protected health information is still at risk as these video conference apps likely do not comport with the typical requirements under HIPAA.

Additionally, the U.S. Department of Justice, Drug Enforcement Administration (the DEA), has permitted licensed physicians providing telehealth services to prescribe controlled substances, such as opioids, without an in-person office visit. Normally, providers must hold at least one in-person office visit with a patient prior to prescribing a controlled substance either via in-person evaluation or telehealth technology. Yet, since the current COVID-19 pandemic constitutes a nationwide public health emergency, the DEA has been able to ease its restrictions under an exception to the Controlled Substances Act. Even as the provision of controlled substances and other forms of treatment via telehealth mediums serves to increase access to healthcare services including behavioral healthcare, there are still concerns of over-prescription amidst the nation's opioid crisis.

As states begin to reopen and the nation determines what our "new normal" looks like, the temporary modifications to various rules and regulations in relation to telehealth services will have to be revisited. Due to the surge in patient use of telehealth services, state and federal governments will have to consider whether to reinstate previous laws and regulations post pandemic. In terms of the federal privacy and security rules, physicians and hospital systems that continue to provide telehealth services will have to seek long-term solutions to prevent data breaches of protected health information while supporting the need for access to care.

Considering that May is Mental Health Awareness Month, it is appropriate to highlight the importance of promoting proper mental health practices and laws surrounding the access to mental health services. The Centers for Disease Control and Prevention (the CDC) issued guidance in regard to coping with stress related to the coronavirus pandemic and encouraged people to take care of their mental health. The CDC expressed the need for an adequate support system as well as maintaining balance and taking care of your own emotional health, whether you are a first responder or not. The Substance Use and Mental Health Services Administration (SAMHSA) also provided considerations for the care and treatment of mental and substance use disorders during the COVID-19 pandemic. Both the CDC and SAMHSA have recommended the use of telehealth or telephonic services for continued mental health and substance use treatment.

While it is uncertain as to whether mental health issues will retain public attention post-pandemic, there is no question that mental health awareness is vital to the promotion of the nation's public health and safety.

Lindsay Lowe is an associate at Wolfe Pincavage in Miami. She represents health care providers in licensing, fraud, waste, abuse and compliance matters.