Pa.’s telemedicine waivers create confusion

April Hynes of Bucks County was diagnosed with stage 4 metastatic breast cancer in August 2020. In what feels like a previous life — before two grueling years of chemotherapy and treatment with a new cancer drug — getting around was mundane. Now, because the medicine used in her treatment plan causes the muscles in her legs to weaken, even something that was once as simple as walking is a challenge.

For the vivacious mother of three, her suddenly sedentary days gave her more time to think about all she would lose if the treatments didn’t work. But, fortunately, they did. April credits her eligibility for a new drug just out of clinical trials and her faith in Christ for bringing about the “miracle” she says she is experiencing today: being cancer free.

This happy moment almost didn’t happen because of what she calls an “unnecessary” veto by Gov. Tom Wolf of a telemedicine bill. April believes the bureaucratic snafus she ran into trying to get a telemedicine appointment at the height of the COVID-19 pandemic almost cost her the ability to find either a clinical trial or new drug just on the market that could save her life. Surprisingly, lawmakers still haven’t passed a telemedicine bill.

When April got the call about her diagnosis in summer 2020, her doctors told her the only thing that could extend her life beyond the expected 13 months was to enroll in a clinical trial or become qualified to try new drugs just out of trial. It’s not as easy as just signing up. Her doctors at the University of Pennsylvania had options — but cautioned that she had to find a doctor at a different hospital to determine if those options were the right course.

» READ MORE: The telemedicine revolution is upon us. Can our laws catch up? | Expert Opinion

At the height of the COVID pandemic, April got a telemedicine appointment at one of the nation’s top cancer centers: Memorial Sloan Kettering Cancer Center (MSK) in New York.

But on the Friday before the appointment, MSK called to cancel. They told her that as a Pennsylvania resident, she could only make an in-person appointment, and the soonest one was in four weeks. If she didn’t get in at MSK for that telemedicine appointment, April would have had to either delay chemo or forego the other options.

“Why can’t I just do telemedicine?” April remembers asking the woman on the other end of the line. The response stunned her: “Call your governor.”

“I was looking at a death sentence and a last chance hope for some miracle drug,” April told me. “And one of the best cancer hospitals in the world is telling me to call my governor instead of seeing a doctor? It’s still so wrong.”

It was at that point in August 2020 when April called me for help. We’ve been friends for over a decade, and April knew I worked in public policy. Together, we contacted her state representative and were able to quickly get her a waiver to satisfy the hospital. The fact that we had to take this step still rankles us both.

The problems for April and other patients like her began early in the pandemic when our lawmakers did something right: They temporarily rolled back red tape to give Pennsylvania residents increased access to critical health-care services across state lines, including medical specialists and mental health clinicians. Lawmakers also created short-term waivers for commonsense reforms like allowing certain practitioners to obtain continuing education for licensure via distance learning.

A complete victory for Pennsylvanians would have been a permanent telemedicine law and the abolition of nearly 100 state health-care licensing regulations that were temporarily suspended or waived during the pandemic. Those moves would create more certainty for patients and providers. Instead, we were delivered a partial victory via stopgap suspensions.

And for a time, it worked — until it didn’t.

The last set of suspended and waived licensing regulations will expire at the end of October. Unless lawmakers vote to permanently codify the changes, they will likely get punted for another renewal period. April can’t imagine more people getting caught in the same kind of confusion that she experienced.

Another source of frustration for April is how telemedicine proposals have become tied to the abortion debate. In each session since 2016, State Sen. Elder Vogel has introduced bills calling for comprehensive and permanent telemedicine legislation.

But this vital reform has been thwarted by politicians fighting a proxy war on abortion at the expense of patients like April who are caught in the middle. State House lawmakers continue to push for a controversial amendment to restrict the prescribing of relatively riskier drugs (including a common medical abortion drug), all but guaranteeing a repeat of Gov. Wolf’s 2020 veto.

“My life is on the line and they’re making it political with abortion? This is my life — other people’s lives they’re talking about,” April said.

“My life is on the line and they’re making it political with abortion?”

April wanted to make public appearances as an advocate for a permanent telemedicine bill, but her treatment limited her options. Still, she did some media interviews and even recorded a message to Gov. Wolf and lawmakers that could be used if she became too sick to testify in person in Harrisburg.

For now, until lawmakers call, April is focused on the challenge of mastering walking again. “It was the greatest moment [last Monday] when I walked into a Phillies game with my family and I could walk around the stadium with them,” April says. “It even felt miraculous walking around the Wawa to get the food to tailgate. I just felt it was a great American moment I didn’t think I would get to experience again.”

Her night was complete when the Phillies won. A permanent Pennsylvania telemedicine policy would be an even bigger victory.

Jennifer Stefano is the executive vice president of the Commonwealth Foundation and a fellow at the Independent Women’s Forum.