Telemedicine in New Jersey: Law, Rules, and Regulations Regarding Remote Healthcare Services

Posted by Michael Hsu on 6/17/20 9:28 AM
Michael Hsu

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New Jersey adopted a telemedicine parity law fairly recently. The law was passed after a year-long debate by New Jersey’s legislators and came into effect on July 21, 2017. 

Here’s a summary of all the rules, regulations, and policies your practice must comply with if you intend to offer telemedicine or telehealth services to patients in the State of New Jersey.

New Jersey telemedicine parity law

The State of New Jersey adopted a telemedicine parity law in 2017, fully embracing telemedicine and telehealth as valid forms of medical care. The law provides clear definitions of telemedicine and its modalities and establishes practice standards. It also enforces telemedicine coverage for NJ Medicaid, commercial health plans, and state-funded health insurance.

We’ll go over all the relevant aspects of telemedicine New Jersey telemedicine parity law covers, but first, let’s take a look at how the state defines telemedicine and telehealth.

Telemedicine and telehealth definitions under New Jersey law

Senate Bill S291, often referred to as New Jersey telemedicine parity law, makes a clear distinction between the terms telemedicine and telehealth.

Telemedicine is defined as the delivery of medical care via electronic communications, information technology, or other electronic means, in order to bridge the gap between a patient at an originating site and a doctor at a distant site. The Bill also states that such services shall be provided through real-time, interactive, two-way communication technologies. 

Under New Jersey’s parity law, the term telemedicine does not include email, instant messaging, phone text, facsimile transmissions, or audio-only phone consultations. 

Telehealth is defined as the use of information and communication technologies to support clinical health care, consultation, patient and professional health-related education, public health, health administration, and other similar services. The term telehealth in NJ parity law encompasses phone consultations, remote patient monitoring, and other electronic means of doctor-patient communication.

Although the two terms both refer to providing healthcare services remotely, the key distinction between them is that telemedicine pertains to the evaluation, diagnosis, and treatment of patients. This is the main reason why it must be delivered through two-way audio-video communication. Telehealth mainly refers to consultation services where physical examination isn’t necessary to provide medical care to patients. 

Other key definitions

Senate Bill S291 provides several other definitions that further define how telemedicine should be practiced in the State of New Jersey. These definitions include:

  • Originating sites
  • Distant sites
  • Asynchronous store-and-forward technology
  • Healthcare providers
  • Cross-coverage service providers
  • On-call providers

Originating site — SB S291 provides a broad definition of an originating site, as any site at which the patient is located at the time of receiving remote healthcare services delivered by means of telemedicine or telehealth. This means that the patient’s home is considered an eligible originating site under NJ law. 

Distant site — Any site at which a healthcare provider — licensed to practice medicine in the State of New Jersey and acting within their scope of practice — is located while providing telemedicine or telehealth services. 

Asynchronous store-and-forward technology — Transmission of images, diagnostics, data, and other medical information that enables patient evaluation without the patient being physically present. The transmission can occur to and from an originating site and to and from a healthcare provider delivering telemedicine or telehealth services. 

Healthcare providers — Any individual with a valid NJ medical license or certification, who provides healthcare services to a patient. The inclusion of this definition, as simple as it may be, makes New Jersey one of the most pro-telemedicine states in the U.S., given that it does not restrict who can provide remote medical care to patients in the state. 

Cross-coverage service providers — Healthcare professionals who offer remote medical care to patients, at the request of another healthcare professional who has an established doctor-patient relationship with the patient. 

On-call providers — Licensed or certified healthcare professionals who can physically provide urgent medical care and tend to the patient’s follow-up needs, designated by the patient’s primary healthcare provider or another healthcare provider of record.

Eligible providers

New Jersey telemedicine parity law doesn’t explicitly state which healthcare professionals can practice telemedicine and telehealth in the state. From the wording of the SB S291, one could arrive at the conclusion that the law does not impose any restrictions on providing remote medical care, so long as the provider is licensed or certified to practice medicine in New Jersey.

The New Jersey State Board of Medical Examiners and the State Board of Marriage and Family Therapy Examiners proposed several rules and regulations in 2019, which apply to various medical professionals who use telehealth and telemedicine. 

Given that the state boards explicitly state who the regulations apply to, they indirectly provide us with a list of eligible telemedicine and telehealth providers. Medical professionals who can practice telemedicine and telehealth in the State of New Jersey include:

  • Physicians
  • Podiatrists
  • Physical therapists
  • Physical therapist assistants
  • Athletic trainers
  • Psychologists
  • Psychoanalysts 
  • Nurses
  • Midwives
  • Hearing aid dispensers
  • Orthotists, pedorthists, prosthetists, and their assistants
  • Genetic counselors
  • Veterinarians
  • Social workers
  • Licensed acupuncturists

The list is quite inclusive, cementing the view that every NJ licensed or certified medical professional can practice telemedicine and telehealth in the state.

New Jersey Telemedicine practice standards

All healthcare professionals practicing telemedicine and telehealth in the State of New Jersey are held to the same standards of care or practice standards that are applicable to in-person settings. 

This includes:

  1. Evaluation
  2. Diagnosis
  3. Treatment 
  4. Discussions regarding the risk and benefits of the patient’s treatment option
  5. Issuance of prescriptions 

Should the telemedicine or telehealth provider determine that the services they would provide remotely would not be consistent with the standards of care, they must advise the patient to seek in-person medical care. 

Establishing a valid doctor-patient relationship

According to New Jersey telemedicine parity law, healthcare professionals delivering remote medical care can establish a valid doctor-patient relationship with their patients, without previously examining them in an in-person setting. 

The state boards are prohibited by law from passing regulations that would enforce in-person examinations as a requirement for delivering telemedicine or telehealth services.

The law also prescribes minimum requirements for establishing a valid doctor-patient relationship:

  • The provider must properly identify the patient prior to engaging in telemedicine or telehealth. At a bare minimum, this includes obtaining the patient’s name, address, date of birth, and phone number. The provider may also request additional information, such as the patient’s photo, social security number, health insurance policy number, or other identifiers.
  • The provider must disclose their identity and credentials to patients prior to a telemedicine or telehealth visit, such as their title, license, and specialty and board certifications. 
  • For initial telemedicine or telehealth encounters, the provider must first review the patient’s medical history and any available medical records. For any subsequent encounter, the provider may review that information prior to the consult or during the encounter. 
  • In case the patient has no healthcare provider of record, the telemedicine or telehealth provider should advise the patient to seek a primary care provider, and may assist them in finding in-person medical assistance in reasonable proximity to the patient.
  • The law also dictates that providers are obligated to determine whether the services they intend to provide via telemedicine or telehealth will be consistent with the prescribed standards of care, prior to each visit and for every patient. If the remote healthcare service cannot meet the standards of care, the provider must refuse the patient and advise them to seek in-person medical care.
  • Following each visit, the provider must make the patient’s medical information available upon their request. The patient may also request that the medical information be forwarded to their primary care provider or health care provider of record.

At first glance, it may appear that providing remote medical care to patients in New Jersey is quite a hassle. With a proper telemedicine solution — like Curogram — you can easily comply with all of the requirements listed above.

Curogram automatically sends electronic patient intake forms a few days in advance of the telemedicine or telehealth encounter. This enables you to both identify the patient and determine whether remote healthcare services will comply with the standards of care, given their medical condition and their manifested symptoms. 

Our platform also allows you to share medical information with your patients in a secure, fully HIPAA compliant manner. 

Exceptions to doctor-patient relationships

SB S291 defines instances when telemedicine and telehealth may be practiced without establishing a valid doctor-patient relationship prior to the online encounter. 

The exceptions include:

  1. Informal consultations by a provider outside of contractual obligations or consultations delivered infrequently or irregularly, where the patient is not expected to provide compensation for consultation services.
  2. Periodic consultations provided by an out-of-state medical professional to a licensed healthcare provider in New Jersey.
  3. Telemedicine and telehealth services provided in response to an emergency or a natural disaster, when said services are delivered free of charge.
  4. Services delivered by an on-call or cross-coverage provider, designated by an absent provider in the same specialty. 

Informed patient consent

New Jersey telemedicine parity law does not require informed patient consent for telemedicine or telehealth services. 

Patient consent is required when forwarding their medical information to the patient’s primary care provider or health care provider of record or when referring the patient to a healthcare provider for in-person medical care. In those instances, the consent can be oral, written, or digital in nature, provided that the method of consent is considered appropriate under the standard of care.

Online prescriptions

Telemedicine and telehealth practitioners in the State of New Jersey can issue online prescriptions to their patients, provided they’ve established a valid doctor-patient relationship. 

This doesn’t mean that an in-person examination is required, but forbids the issuance of medications based solely on the patient’s responses provided through an online questionnaire. A patient must come in for an online appointment and be evaluated and diagnosed by a telemedicine or telehealth provider before the provider can issue an online prescription. 

This rule doesn’t apply to all drugs. The prescription of Schedule II controlled dangerous substances — such as opiates, oxycodone, methadone, and fentanyl — will require an in-person examination of the patient. In addition, an in-person visit must be conducted at least once every three months, for the duration of the treatment.

The one exception here is when a telemedicine or telehealth provider is prescribing a stimulant which is a Schedule II controlled dangerous substance to a minor, provided that: 

  1. The examination is conducted through a live, two-way video platform
  2. The provider has previously obtained written consent from the patient’s parent or guardian that removes in-person examination requirements 

Location restrictions

There are no location restrictions under New Jersey law for telemedicine and telehealth encounters. All practitioner offices and medical facilities are considered eligible distant sites, and telemedicine and telehealth services can be provided regardless of the patient’s location within the State of New Jersey.

Documenting telemedicine encounters

Telemedicine and telehealth providers must document all virtual encounters and maintain a detailed record of patient care. This must be done in accordance with all applicable state and federal statutes and regulations regarding recordkeeping, confidentiality, and disclosure of the patient’s medical record. 

Practitioners must also ensure that all the medical information exchanged in telemedicine or telehealth encounters is stored and shared in a HIPAA compliant manner. Without a proper telemedicine solution, you would have to manually update your electronic health record and seek out a third-party provider for storage and archiving capabilities. 

Curogram is fully HIPAA compliant, integrates with over 700 EHRs, and comes with built-in safeguards and automated data backup. We’ve handled all the technical details and compliance requirements, so you can focus on providing medical care to patients in a 100% secure environment. 

With Curogram, all the medical information is automatically updated after each virtual visit, so you don’t have to waste valuable time on redundant administrative tasks. 

Curogram EHR integrations

eClinicalWorks

Athena

Epic

Cerner

DrChrono

NextGen

Practice Fusion

CareCloud

Kareo

OfficeAlly

See More Integrations Here

Business registration for telemedicine or telehealth organizations

One thing you should keep in mind is that New Jersey law requires telemedicine and telehealth organizations operating in the state to register with the Department of Health annually. You must also submit annual reports detailing the organization’s telemedicine and telehealth activity, along with all medical data related to all virtual encounters with the patients. 

The law defines a telemedicine or telehealth organization as a “corporation, sole proprietorship, partnership, or limited liability company that is organized for the primary purpose of administering services in the furtherance of telemedicine or telehealth.”

It’s evident that it applies to practices primarily providing medical care remotely, but it’s unclear whether medical professionals who periodically offer telemedicine and telehealth services to supplement in-person medical care will have to file these annual reports.

Cross-state licensing

New Jersey’s telemedicine parity law explicitly states that practitioners must be licensed or certified in the state. The Garden State hasn’t proposed legislation to join the Interstate Medical Licensure Compact, so medical professionals outside of New Jersey cannot offer remote healthcare services to patients in the state. 

Insurance coverage

What’s interesting to note is that the New Jersey telemedicine parity law does not enforce payment parity for telemedicine and telehealth services. 

It states that a “carrier that offers a health benefits plan shall cover telemedicine and telehealth services on the same basis” as in-person encounters. That said, a carrier can limit coverage of services delivered via telemedicine and telehealth, but may not charge any deductible, copayment, or coinsurance for said services if the amount exceeds the amount applicable to in-person consultations.

The law also notes that remote healthcare services cannot exceed the reimbursement rates that apply to the same services that are delivered in-person. 

New Jersey Medicaid

Given that New Jersey’s telemedicine parity law went into effect fairly recently, the state’s Medicaid program is yet to develop detailed policies regarding telemedicine and telehealth. 

As things stand, NJ Medicaid’s guidelines only pertain to telepsychiatry. If you intend to provide remote healthcare services to NJ Medicaid program members, we urge you to contact the state’s Medicaid and inquire about eligible telemedicine and telehealth services.

As practitioners and patients in New Jersey progressively embrace telemedicine and telehealth, it would be reasonable to expect the state’s Medicaid program to update its policies. Despite only dealing in telepsychiatry, some of the existing policies are likely to remain the same. 

For instance, NJ Medicaid will reimburse remote patient monitoring, as well as telemedicine and telehealth services delivered through live, two-way video communication. Other rules regarding telemedicine and telehealth coverage are the same as with private payers, meaning that the fees cannot exceed the amount applicable to services provided in person. 

As is the case with carriers, NJ Medicaid and NJ FamilyCare programs may limit the coverage of telemedicine and telehealth services. That’s why providers should contact NJ Medicaid prior to providing remote medical care to the program’s participants, to inquire whether specific telemedicine and telehealth services are reimbursable. 

Embrace telemedicine in New Jersey with Curogram

Curogram is a telemedicine solution designed specifically for healthcare professionals.

It’s a fully HIPAA compliant platform that comes with built-in safeguards and allows you to set up your virtual clinic in less than 48 hours, without having to worry about the technical details. Curogram is simple and easy to use — both for medical professionals and patients. 

Curogram has you covered on all fronts! Send automated appointment reminders to reduce no-shows by 75%, communicate with your patients via SMS, share PHI among staff members and partners, host video appointments, and bill your patients — all from a single dashboard.

Here’s  why you’ll love Curogram

Complete EHR integration

Curogram fully integrates with your EHR, so medical information in your electronic health record is automatically updated after each encounter. This eliminates the need for manual entry and allows your doctors and medical staff to dedicate more time to treating patients. 

Smart appointment reminders

Curogram assigns your practice with a local number and allows you to create templated appointment reminders that the platform sends automatically before each scheduled visit. This way, you can ensure that your patients never miss an online appointment!

Automated electronic patient intake forms

Curogram sends out automated electronic patient intake forms to your patients a few days in advance of the appointment. You’ll have all the necessary medical information by the time you admit the patient and can advise an in-person visit if you deem it necessary, given the patient’s medical condition. 

Virtual waiting rooms

Curogram mimics your existing workflows, allowing your staff to transition easily to an online working environment. The virtual clinics you create with Curogram come with waiting rooms, where your medical staff can continue working in the same way as if the visits were conducted in-person. 

If you want to learn more about Curogram and test out the platform — click here and start your free 14-day trial!

Telemedicine by State

Don’t see your state? We just haven’t written about it yet! Stay tuned on our blog or check out our article on telemedicine reimbursement by state.

Telemedicine by State in the US

Alabama

Indiana

Nebraska

South Carolina

Alaska

Iowa

Nevada

South Dakota

Arizona

Kansas

New Hampshire

Tennessee

Arkansas

Kentucky

New Jersey

Texas

California

Louisiana

New Mexico

Utah

Colorado

Maine

New York

Vermont

Connecticut

Maryland

North Carolina

Virginia

Delaware

Massachusetts 

North Dakota

Washington

Florida

Michigan

Ohio

West Virginia

Georgia

Minnesota

Oklahoma

Wisconsin

Hawaii

Mississippi

Oregon

Wyoming

Idaho

Missouri

Pennsylvania

 

Illinois

Montana

Rhode Island

 

Topics: telemedicine

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