New Jersey Telemedicine Providers: Do You Know the “Ins and Outs” of the New Law?

Written by Deirdre Hartmann, CPA, Partner

Telemedicine history was made on July 21, 2017, as Governor Chris Christie signed off on the law allowing healthcare providers to see patients virtually using modern electronic methods that don’t require patients to physically come into the doctor’s office in New Jersey. No in-person initial appointments required. As exciting as this major advancement in the healthcare industry is, it is important that telemedicine providers know the specifics of the law.

Before jumping into practice standards, it is important to know the difference between telemedicine and telehealth. Below is the definition of both services, as explained by Health Care Law Today:

Telemedicine: The delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a health care provider who is located at a distant site and a patient who is located at an originating site. The term does not include “the use, in isolation, of audio-only telephone conversation, electronic mail, instant messaging, phone text or facsimile transmission.”

Telehealth: The use of information and communications technologies, including telephones, remote patient monitoring devices, or other electronic means, to support clinical health care, provider consultation, patient and professional health-related education, public health, health administration and other services.

Below are some basic practice standards physicians will need to adhere to:

Practice Standards Basics

  • As a telemedicine provider, your identity, professional credentials and contact information must be available to patients during and after providing healthcare services, in which your contact information must be available to the patient for at least 72 hours after providing services.
  • The patient’s medical information must be made available to the patient upon request.
  • The provider must refer the patient to appropriate follow-up care when necessary, including making necessary referrals.
  • Diagnosis, treatment and consultation recommendations are held to the same standard of care or practice standards as in-person settings.
  • When prescribing medication, a provider is able to prescribe via telemedicine only after establishing a valid provider-patient relationship.
  • The law does not require patient informed consent for telehealth services.
  • Telehealth providers must keep a complete record of patients’ care and comply with all State and federal statutes and regulations for recordkeeping, confidentiality and disclosure of patients’ medical records.
  • All HIPPA rules apply.

Other notable highlights

  • The law requires all telemedicine or telehealth services operating in New Jersey to register with the Department of Health annually, and submit annual reports on activity.
  • These reports will include patients’ race and ethnicity; diagnostic codes; evaluation management codes; source of payment for consults.

State Licensure Requirements: Another benefit of telehealth services is that providers can connect with patients in other states. According to the Telehealth Resource Center, when this happens, “the originating site (the location of the patient) is considered the ‘place of service.’” Because of this, providers must adhere to licensing rules and regulations of the state in which the patient is stationed in.

Technology: Under the New Jersey law, services must be provided using interactive, real-time, two-way communication technologies. It is important to note that this requirement does not extend into telehealth services. Providers practicing telemedicine or telehealth services may use interactive audio with Store-and-Forward technology. This allows the patient and provider to exchange images, diagnostics, data and medical information.

Insurance Coverage for New Jersey Telemedicine: Currently, there is broad coverage of telemedicine and telehealth services. The new law does not enforce a payment parity requirement, but sets the in-person reimbursement rate as the maximum ceiling for telemedicine and telehealth reimbursement rates.

  • With Medicaid and Medicaid managed care, the law states that reimbursement payments may be provided either to the individual practitioner who delivered the reimbursable services, or to the agency, facility or organization that employs the individual practitioner. A carrier may limit coverage to services that are delivered by health care providers in the health benefits plan’s network, but may not charge any expenses delivered through telemedicine in an amount that exceeds those expenses at an in-person consultation.
  • With commercial health insurance plans, the law states that reimbursement payments may be provided either to the individual practitioner who delivered the reimbursable services, or to the agency, facility or organization that employs the individual practitioner. A carrier may limit coverage to services that are delivered by health care providers in the health benefits plan’s network, but may not charge any expenses delivered through telemedicine in an amount that exceeds those expenses at an in-person consultation.

For more information, please contact me directly at (973) 328-1825 or dhartmann@nisivoccia.com.

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