In 2024, the future of virtual behavioral health hangs in the balance as the federal government weighs the permanence of telehealth flexibilities established during the COVID-19 pandemic. These flexibilities, particularly crucial for providers offering care to Medicaid beneficiaries or prescribing controlled substances for conditions like substance use disorders (SUDs), may face changes or expiration later in the year. Despite this uncertainty, there's a growing acknowledgment of telehealth's efficacy, with Health and Human Services Secretary Xavier Becerra advocating against allowing these flexibilities to lapse.

Telehealth not only offers extensive benefits to patients, including increased access to specialized clinicians and support for conditions like opioid use disorder (OUD), but it also presents challenges tied to federal and state regulations. The lack of a permanent framework for prescribing controlled substances at the federal level and varying state regulations pose obstacles for providers navigating compliance while expanding their reach. Meanwhile, advocacy efforts push for interstate licensure compacts to streamline access to telehealth services across state lines, though challenges persist, particularly for Medicaid beneficiaries seeking SUD treatment. With major regulatory changes looming and the fate of telehealth in the balance, stakeholders emphasize the urgency of federal policymaking and advocate for measures to ensure continued access to virtual behavioral health services.