- One of the last states to regulate telehealth is moving forward with legislation that would permit video visits and consults and store-and-forward technology – but not healthcare delivered by phone, e-mail or text message.
The New Jersey Senate’s health committee has unanimously approved S.291, which would enable clinicians in the Garden State to establish a valid physician-patient relationship via telehealth, require state health plans and private plans that cover state employees to reimburse at the same rate as in-person care, and prevent those plans from mandating an in-person visit before telehealth use.
The bill also allows out-of-state healthcare providers to treat New Jersey residents via telehealth as long as they have a reciprocal medical license; New Jersey lawmakers enacted a rule in 2014 allowing doctors from other states to treat patient in New Jersey as long as the medical license they hold in their state aligns with New Jersey requirements.
And it directs New Jersey’s Board of Medical Examiners to study the Federal of State Medical Board’s Interstate Medical Licensure Compact, which establishes a streamlined licensing process for providers wishing to practice across state lines. Within six months of the bill’s passage into law, the board would issue a recommendation on whether New Jersey should join the compact, which currently has 17 member states.
A companion bill in the State Assembly, A.1464, awaits a committee vote. If approved, the two bills would then be integrated into one bill for a final vote.
"Telemedicine is especially vital for patients who suffer from chronic illness, seniors who are homebound and families who live in rural areas where they would have to travel very far to receive medical care," State Sen. Diane Allen (R-Burlington), one of the bill's sponsors, told NJ.com following the Sept. 26 Senate committee vote. "No one should have to choose between paying for groceries and traveling to see a doctor. By legalizing telemedicine, we can bring the cost of healthcare down and expand access to a variety of health services for millions of new patients."
The bill avoids conflicts popping up in other states by establishing broad definitions for the originating site and the remote location of the patient. Lawmakers in Arkansas are currently grappling with a proposal that would limit originating sites to healthcare settings, effectively eliminating the home as a telehealth site and handcuffing many remote patient monitoring programs.
It also establishes that New Jersey’s Medicaid and NJ Family Care plans, private plans that cover state employees and managed care plans reimburse for telehealth at the same rate as in-person care.
That doesn’t sit well with Warren Sanders, president of the New Jersey Association of Health Plans, who argues payers should have some leeway in determining how to pay for virtual visits.
"We would argue there should be flexibility to allow for different pay structures," he told NJ.com, adding that "only seven states require reimbursement for telemedicine services to the same extent as for in-person treatments and consultations."
The decision to exclude audio-based, e-mail and text message communications from the list of approved telehealth platforms reflects a growing trend among states to exclude commercial telehealth platforms that rely on phone calls or messaging platforms.
Officials noted that the 53-page bill had been amended often after it was introduced in January, with the Medical Society of New Jersey arguing that any state legislation preserve the quality of care inherent in face-to-face communications.
The legislation might improve the state’s standing in the eyes of the American Telemedicine Association, which gave the state a low mark in one of its most recent report cards. In its June 2016 report, the ATA graded New Jersey at ‘C’ for coverage and reimbursement, while giving the state an ‘A’ for physician practice standards and licensure.