The “State” of Telehealth: New Jersey

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This article is the first post in our new “State” of Telehealth series in which we discuss innovation on a state level on the expansion of telehealth access, coverage and reimbursement.

On January 14, 2021, the New Jersey Senate Committee approved a proposed bill (Bill S-2559, the “Bill”) that, if signed into law, would amend New Jersey’s existing telehealth law and expand reimbursement for covered services provided via telehealth.

The Bill sponsored by Senators Vin Gopal and Nia Gill would require that insurance providers and Medicaid (note that this applies to all carriers that offer a health benefits plan in New Jersey) reimburse providers for services rendered via telehealth the same amount they would receive as if the services were provided in-person. Currently, New Jersey law provides that the rates for telehealth services are negotiable up to the amount that could be charged as if such services were provided in-person. This means, that more often than not, the reimbursement rates for telehealth services is lower than the rate a provider would receive for those same services if performed in-person. The Bill is intended to ensure that telehealth services achieve pay parity with in-person services allowing providers to be compensated equally for the telehealth services that they render.

In line with the Bill’s focus on expanding reimbursement for telehealth services, the Bill also prevents Medicaid and NJ Family Care from requiring that telehealth services be provided at a certain location in order to be eligible for reimbursement. The Bill expressly prohibits payors from:

  1. Imposing any restrictions on the location or setting of the distant site used by a telehealth provider; and
  2. Restricting the ability of a telehealth provider from using any electronic of technological platform, including, interactive, real-time, two-way audio in combination with asynchronous store and forward technology without video capabilities, to provide telehealth services if the standard of care being provided is the same and the telehealth services are being provided in accordance with applicable law.

Moreover, the Bill requires that the telehealth provider meet the same standard of care that they would observe if the visit was in-person.  So long as this standard is met, the telehealth provider may use any technology platform that they deem appropriate to provide the telehealth services to a patient that is located anywhere that the provider deems acceptable.

This approach was no doubt heavily influenced by the COVID-19 pandemic, and the need increase on telehealth utilization in the state. Senator Gopal announced his support for the Bill stating that “Telemedicine is medicine—and for many New Jerseyans, it’s one of the best options they’ve got. We can’t let bureaucratic red tape and old ways of thinking obstruct new ways of delivering healthcare services. This pandemic has been a case study in how effective—and, in many cases, how much more accessible—telehealth and telemedicine can be for New Jerseyans who need it. Let’s end the discrimination against virtual care and make sure that everyone can get coverage for the medical services they need.”

Stay tuned for additional posts in our “State” of Telehealth series.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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