Governor J.B. Pritzker extended the majority of his executive orders in response to COVID-19 through March 6, 2021. To the great relief of many physicians and other health care providers, the extension included Executive Order 2020-09 on telehealth. But, what does this mean for telehealth after the pandemic? This remains a question on everyone's minds as health care providers wait to see how long these extensions will last.

Prior to the pandemic, providing telehealth services in Illinois was fairly onerous, with many stringent requirements affecting both the provider and the patient. The original Executive Order 2020-09 was issued on March 19, 2020 and described that all health insurers regulated by the Department of Insurance must cover telehealth services for in-network providers and reimburse providers at the same rate as in-person visits. These insurers were prohibited from imposing any cost-sharing for in-network providers. This was a tremendous relief in the initial stages of the pandemic, allowing providers to treat patients via remote telehealth platforms without any concerns that they would not be reimbursed for such services.

Previous restrictions on telehealth required an audio and video system permitting two-way, live interactive communication between the patient and the distant site health provider. This was often called real-time telemedicine or synchronous telemedicine. It typically required secured, encrypted videoconferencing software for the patient encounter. It had strict privacy requirements and did not allow for platforms such as Skype, FaceTime or even telephone visits.

COVID-19 forced everyone to recognize the need to relax these rules and provide greater access to care for individuals without risking the spread of the virus. With the executive order, telehealth could now be audio or video. Providers could use non-public facing communications like FaceTime and Skype, and could even use just their telephones for patient encounters. In addition, the new rules expanded mental health services in the area of telehealth and expanded who qualified as providers, as long as these permitted providers were licensed and authorized to practice in Illinois.

There were many efforts even prior to the pandemic to expand telehealth in Illinois. Now that many providers, practices and hospitals have expanded and enhanced their telehealth services and capabilities, many are hopeful these new relaxed rules on telehealth will be here to stay. Many are predicting long-term, definite change in the area of telehealth, but only time will tell whether we see these newly expanded and relaxed telehealth rules survive beyond the pandemic.