[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/New-Jersey-welcome.jpg” thumb_width=”150″ /]With New Jersey’s telemedicine regulations
now signed into law by Governor Christie to be effective 21 July, both providers and payers are adjusting to what the expansion means for those covered by Medicaid, Medicaid managed care, commercial health plans, and NJ state-funded health insurance. Our 27 June
article reviews key points, and they are largely positive for expanding telemedicine in the (now official) Garden State. However, the payment parity part was diluted in the final version, with the in-person reimbursement rate set as the maximum ceiling for telemedicine and telehealth reimbursement rates.
Unique parts of the NJ bill require:
- Telemedicine or telehealth organizations operating in NJ to annually register with the Department of Health
- Submit annual reports on activity and encounter data, which will include patient race and ethnicity, diagnostic and evaluation management codes, and the source of payment for the consult (final details determined by succeeding legislation)
- A seven-member New Jersey Telemedicine and Telehealth Review Commission
- Mental health screeners, screening services, and screening psychiatrists are not required to obtain a separate authorization in order to engage in telemedicine or telehealth for mental health screening purposes
Full reviews of the legislation are available from law firms Foley & Lardner and in the National Law Review by an attorney from NJ firm Giordano, Halleran & Ciesla.
The years-long telemedicine battle in the populous state of New Jersey–the ever-contradictory home of history, high taxes, ‘the Boss’, Newark Airport, and some of the world’s finest beaches and resorts–has finally concluded with a strong win. Last Thursday, the NJ Legislature unanimously passed two bills that set telemedicine practice and payment standards. The General Assembly passed A.1464 and then hours later, the State Senate passed its bill (S.291). Governor Chris Christie had already indicated his support and his signature is expected once both bills are formally reconciled. The new regulations will be effective immediately.
The bill defines telemedicine as doctor-patient two-way videoconferencing and store-and-forward technology, omitting audio-only, email, texting, and fax as usual on the consults. Telehealth is defined as communications technologies including remote patient monitoring and telephone to support clinical health care, provider consultations, and health-related education. No pre-qualifying in-person visits are required to establish a “proper provider-patient relationship” except for conditions requiring treatment with Schedule II controlled dangerous substances. Another exception is for unpaid consults in the wake of an emergency or disaster–something that NJ is experienced with, having been hit hard in the past by hurricanes.
Healthcare providers (inclusive of doctors, nurses and other healthcare professionals) must be licensed in the state and telemedicine/telehealth organizations must register with and submit reports to the Department of Health. A seven-member Telemedicine and Telehealth Review Commission will be set up within six months and will review DOH reports that contain de-identified data on usage, diagnostic code, and payment. These public reports could provide valuable insights on the efficacy of telemedicine and telehealth treatment.
The bill includes full parity of telemedicine payment with in-person visits for both public (Medicaid, state benefit plans) and private insurance plans. There is also parity of a different type affecting mental health providers, with mental health screeners, screening services, and screening psychiatrists not being required to obtain a prior authorization or a waiver prior to engaging in telemedicine and telehealth. (more…)
Big bets were made on telemedicine (video doctor-patient consults) in 2014. This Editor closed her 18 December article with ‘telemedicine providers received a $200 million+ vote of confidence from tough-minded investors. We’ll see if 2015 results fulfill these whale-at-Monte-Carlo wagers.’ Here may be the start of a tipping point. New York State’s new law requiring insurer reimbursement for telehealth services went into effect 1 January, making NY the 22nd state to require payers to pay up for virtual visits. Permitted providers are physicians, dentists (!), physician assistants, psychologists and social workers. This provider list is considerably broader than Medicare’s new rules applying telehealth for patients with two or more chronic conditions, which is tied to physicians’ offices and contracted third parties. Also cheering the industry are that Indiana, Iowa and Tennessee are holding hearings on potential legislation, with Missouri at the legislative bill stage. (more…)