The COVID-19 pandemic has necessitated the suspension of some long-standing regulations. However, as rules and regulations are set aside, the insurance industry will have to face the long-term implications of these changes once the crisis has passed.
After COVID-19, there will likely be much second-guessing and reviewing of industry capabilities to be used in the future. As that review occurs, the validity of regulations that were suspended will be challenged going forward. Some will be easily reinstated. For example, the regulations that surround the safe production and introduction of pharmaceuticals will likely be reinstated, with more careful preplanning on how and when to suspend them again should the need arise.
One regulation that may be critically reviewed, however, is New York’s suspension of doctors practicing only in their licensed state. This suspension was meant to enable doctors to provide care through telemedicine across state lines—and more directly to the hot spot that is New York City. As the crisis grows and becomes more acute in other states, this action by New York is likely to be replicated.
Telemedicine was already a growing trend, and it will likely gain more wind in its sails as a result of increased use during this pandemic. It is possible the notion of restricting care by state boundaries will come under scrutiny.
If this restriction were permanently lifted, the impact would be significant. Not only would it expand health-care coverage to remote and rural citizens, but it would allow expertise and services to “float” without a physical presence, enabling care to be provided under a more favorable cost model.
Obviously, there is a large infrastructure built around the current regulation system that will need to respond. Issues that can be ignored in a short-term crisis have broader implications when moving back to a form of normalcy. How would doctors and health-care providers be licensed, reviewed, and regulated? How would medical protocols be determined and administered? Is the national infrastructure ready for an easing of state-controlled health care? The adoption and implementation of digital medical standards is not universal.
The implications of these changes on the insurance industry could be enormous. Should the “walls” around states regulating providers fall? Can the entire state-oriented workers’ comp industry rethink its managed care practices, including initial nurse triage, provider networks, bill repricing, and panel and referral reviews? Do provider groups go virtual with large memberships? How might this impact negotiations between doctors and insurance companies?
It is reasonable to expect, given other recovery activities, that regulations of health-care providers will return to state oversight. However, this may only be in the near term. Once the world catches its breath and looks carefully at services delivered effectively through digital means, this subject may be revisited. The need for business and technical agility will once again prove to be a core competency required of carriers.
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