- Telemedicine legislation headed to New Jersey Gov. Chris Christie’s desk would, among other things, enable physicians to use telehealth to establish a doctor-patient relationship, ensure the same standards of care as an in-person visit, and ensure coverage and payment parity for private payers, state Medicaid and some other health plans.
New Jersey’s State Senate approved S.291 last Thursday by a 38-0 vote, just hours after the State Assembly passed A.1464 by a vote of 73-0. The unanimous votes conclude more than a year of back-and-forth negotiations to set standards for the fast-growing technology.
"The benefits to telemedicine are enormous," State Assemblywoman Pamela Lampitt (D-Camden), the leader of a six-legislator group sponsoring the Assembly bill, said in a statement. "It will make it quicker and easier to access treatment, drive up practices, lower costs and, most importantly, make sure patients get the treatment they need, when they need it, to improve their long-term health."
"We have not been immune to the nationwide doctor shortage," added state Sen. Diane Allen (R-Burlington), one of seven sponsors of the Senate bill. "Expanding access to quality, affordable healthcare is the right thing to do, especially in these uncertain times. This bill could bring the cost down for millions of new patients."
Legislators avoided a potential controversy when they amended the bill to eliminate a proposed three-year deadline on using telehealth to establish the doctor-patient relationship with new patients, after which doctors would have had to meet new patients in person before moving to telehealth. That limit had been part of an amendment submitted during a June 12 public hearing before the Assembly’s Appropriations Committee - which prompted the ERISA Industry Committee (ERIC) to withdraw its support.
With Christie’s expected signing of the bill, New Jersey will be one of the last states to formally adopt definitions of both telemedicine and telehealth and to set guidelines for their use.
Included in the definition of telemedicine is a ban on physicians solely using audio-only telephone, e-mail, text, Fax or instant messaging – technologies that have been banned in several states for fear they don’t meet the standards of an in-person exam. The new law establishes telemedicine as a platform that uses interactive-real-time, two-way communication technologies.
With regard to asynchronous or store-and-forward technologies, the bill stipulates that physicians can use the platform “for the electronic transmission of images, diagnostics, data, and medical information; except that the health care provider may use interactive, real-time, two-way audio in combination with asynchronous store-and-forward technology, without video capabilities, if, after accessing and reviewing the patient’s medical records, the provider determines that the provider is able to meet the same standard of care as if the health care services were being provided in person.”
In terms of parity, the bill calls for state Medicaid and NJ FamilyCare programs, private payers and public employee health plans to cover and reimburse at the same rate as an in-person visit. Private insurers in some states have fought back against parity, saying they should be able to set reimbursement rates as the market dictates.
The bill also calls for the establishment of a seven-member Telemedicine and Telehealth Review Commission within six months of passage.
The commission will be responsible for reviewing information reported by all healthcare providers registering in the state as telemedicine and telehealth organizations, and making “recommendations for such executive, legislative, regulatory, administrative, and other actions as may be necessary and appropriate to promote and improve the quality, efficiency, and effectiveness of telemedicine and telehealth services provided in New Jersey.” That report will be due within two years after the commission meets.