Telemedicine in New York: Laws, Policies, Rules, and Regulations

Posted by Michael Hsu on 5/31/20 7:13 AM
Michael Hsu

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The state of New York is quite open to telemedicine. Governor Andrew Cuomo signed the New York telehealth parity law in 2014, and it went into effect in 2016. The biggest impact NY’s parity law had on the practice of telemedicine in the state was the fact that it authorized coverage for telehealth services by Medicaid, private insurance, and state employee health plans.

This made remote healthcare services a much more viable option for patients in New York since now they don’t have to pay extra for remote visits to the doctor’s. The parity law transferred reimbursement responsibilities to commercial insurers and Medicaid in all events where services delivered via telehealth would be covered if they were delivered in person.

Apart from the telehealth parity law, the New York State Office of Mental Health’s (OMH), New York State Department of Health (DOH), and Office of Addiction Services and Supports (OASAS) outline additional rules and regulations telemedicine and telehealth practitioners in the state must abide by. 

In the face of the COVID-19 emergency, the New York State Department of Financial Services (DFS) announced amendments to the existing regulations, encouraging New Yorkers to seek medical help from the safety of their homes. 

If you’re interested in offering telemedicine and telehealth services in the State of New York, now’s as good a time as any. Let’s take a closer look at all the relevant telehealth policies in New York. 

New York telehealth policies

Telemedicine and telehealth are often used interchangeably. Some state laws do make the distinction between the two, meaning that different regulations may apply to telemedicine and telehealth, respectively. 

In the State of New York, this isn’t the case. New York law views telehealth as a comprehensive term that includes telemedicine. The New York Insurance Law and Public Health Law provide a similar definition of telehealth:

“The use of electronic information and communication technology to deliver health care to patients at a distance.” 

Under New York’s Public Health Law, these services include:

  • Assessment
  • Diagnosis
  • Treatment
  • Consultation
  • Education
  • Care management
  • Self-management of a patient

An important thing to note is that, in New York state’s law, telehealth is limited to three modalities:

  1. Telemedicine
  2. Store-and-forward
  3. Remote patient monitoring

Note that under New York law, telehealth explicitly excludes audio-only, fax-only, and messaging-only transmissions. This does not mean phone consultations or messaging your patients is strictly prohibited. 

You may use these channels to support your telehealth and telemedicine efforts, but the remote services provided must also include audio-video appointments for the purpose of assessment, evaluation, diagnosis, and treatment. 

Curogram is a perfect solution for practicing telehealth and telemedicine in the State of New York. Our robust telemedicine solution enables you to create virtual clinics and admit patients in a secure, fully HIPAA compliant environment. 

Curogram also helps streamline your telemedicine workflows, facilitates collaboration between staff members, and enables fast two-way communication between practitioners and patients. 

Telemedicine in New York

The New York State Medicaid provides the definition of telemedicine as leveraging synchronous audio-visual communication to deliver healthcare services to patients remotely. It also defines that this includes the patient being at an originating site while the telehealth provider is at a distant site. 

Store-and-forward

Store-and-forward refers to the electronic transmission of protected health information (PHI) between healthcare providers. This information includes the patient’s medical information, such as: 

  • Test results
  • Patient-specific digital images
  • Pre-recorded videos

NY laws allow healthcare providers to share PHI, with patient’s consent, with each other for the purpose of providing treatment to said patient, whether in-person or remotely.

Remote patient monitoring

This refers to leveraging both synchronous and asynchronous communication technologies to collect PHI and other medical data from a patient at an originating site and transmitting that data to a provider at a distant site. The information can only be used to provide the treatment and management of patient’s medical conditions that require regular monitoring. 

According to NYS Medicaid, these conditions include but are not limited to:

  • Congestive heart failure
  • Diabetes
  • Mental or behavioral problems
  • Chronic obstructive pulmonary disease
  • Polypharmacy
  • Technology-dependent care, such as continuous oxygen

There are a few more things to consider regarding remote patient monitoring (RPM). It must be ordered and billed by a physician, nurse practitioner, or midwife, provided that the patient has an existing ongoing relationship with the telehealth practitioner or intends to enter one. 

Medicaid also notes that patients must be seen in-person if the condition requires follow-up care. When the patient’s condition is deemed to be stable and/or controlled, the telehealth practitioner should discontinue RPM.

Who is eligible to provide telemedicine services in New York?

NYS Medicaid provides a comprehensive list of healthcare providers eligible to offer telehealth and telemedicine services in the state:

  • Physicians
  • Physician assistants
  • Physician specialists, including psychiatrists
  • Psychologists
  • Nurse practitioners
  • Registered professional nurses
  • Diabetes educators
  • Asthma educators
  • Podiatrists
  • Optometrists 
  • Dentists
  • Speech-language pathologists or audiologists
  • Midwives
  • Hospitals
  • Hospices
  • Home care service agencies

This goes to show that the State of New York has fully embraced telehealth and telemedicine. All healthcare professionals in the state can offer remote healthcare services to their patients and can even fully switch to telemedicine and only offer remote appointments. 

Before being able to offer remote healthcare services, telehealth providers in New York must:

  1. Be licensed and registered in accordance with NYS Education Law and enrolled in NYS Medicaid
  2. Operate within their scope of practice
  3. Be credentialed and privileged at both the originating and distant sites when telehealth sites are provided by an Article 28 facility—a hospital, nursing home, or diagnostic treatment center

Agency approval to deliver telemedicine services

Healthcare professionals don’t need specific approval from the New York State Department of Health (DOH) or Office for People With Developmental Disabilities (OPWDD) to practice telehealth in New York. 

That said, the OPWDD prohibits Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD) to be delivered via telehealth solutions. These services must be delivered in-person.

The situation is a bit different when it comes to the New York State Office of Mental Health’s (OMH) and Office of Addiction Services and Supports (OASAS). 

OMH requires approval by the field office, and you will have to submit a written plan and attestation before offering mental health services remotely. 

New York takes providing support to people struggling with addiction quite seriously. That’s why OASAS is a bit more strict and requires approval for a certified program before enabling healthcare professionals to provide telepractice services. It also enforces some limitations to telepractice services that providers must adhere to. 

You must first submit “Plan and Attestation” that details: 

  • Possible site locations for the practitioner and patients
  • Contracts or agreements between patients and practitioners
  • Services you intend to deliver
  • Assurances of confidentiality

OASAS also limits telepractice services to:

  1. Admission assessment
  2. Psycho-social evaluations
  3. Mental health consultations
  4. Medication-assisted treatment and monitoring
  5. Other services as approved by OASAS

The Office also states that patients must consent to receiving telepractice services and that they must be evaluated for suitability before attending a telepractice session.


Recognized telehealth modalities and regulations by agency

Agency

State Education Department

Department of Health

Office of Mental Health

Office of Alcohol and Substance Abuse Services

Office for People With Developmental Disabilities

Recognized modalities 

Static data transmission and interactive teleconferencing

Telemedicine


Store-and-forward technology


Remote patient monitoring

Telepsychiatry

Telepractice

Telemedicine


Store-and-forward technology


Remote patient monitoring

Regulations

Title VIII licensure requirements for practitioners

None

14 NYCRR Part 596 

14 NYCRR Part 830 

14 NYCRR Part 679 

Cross-state telemedicine licensing

New York has also introduced legislation enabling the state’s participation in the Interstate Medical Licensure Compact. This allows healthcare practitioners to provide telehealth and telemedicine services to patients with originating sites in New York, provided they are licensed to practice medicine in the State of New York and have joined the NYS Medicaid program.   

Obtaining patient consent

Regarding patient consent, New York law dictates that informed patient consent is only necessary when providing telepsychiatry services. This is aligned with OASAS’ requirement for patient suitability evaluation prior to providing remote mental health services. 

As far as other telehealth and telemedicine services are concerned, the lack of informed patient consent requirement implies that consent is achieved when the patient chooses to receive remote healthcare services. That said, we would still advise you to inform your patients of potential security and confidentiality risks that accompany telehealth. 

Medicaid also provides multiple guidelines regarding delivering telehealth and telemedicine services to the program’s members.

Medicaid patients receiving remote healthcare services must:

  1. Have the right to decline such services and be informed of alternatives
  2. Be informed about the role of the practitioner at the distant site, as well as medical professionals at the originating site
  3. Be informed regarding the location of the distant site and the technology used to provide telehealth and telemedicine services
  4. Have the right to have medical staff immediately available to them at an originating site, to provide necessary medical care in the event of an emergency
  5. Be informed of all parties participating in the telehealth transmission
  6. Have the right to select a different telehealth service provider

Prescription requirements

New York law does not impose any restrictions on issuing prescriptions through telehealth and telemedicine when medically appropriate. 

One thing to note here is that OASAS states that only medical professionals with Drug Enforcement Administration (DEA) approval can prescribe and administer buprenorphine. This includes:

  1. Physicians
  2. Physician assistants
  3. Nurse practitioners

Documenting telehealth and telemedicine encounters

New York laws don’t provide any information regarding the documentation of telemedicine encounters. This is probably the case because it would be redundant, given that HIPAA rules state that all medical information in telemedicine should be documented and treated with the same care as in an in-person environment. 

Maintaining and updating your electronic health record (EHR) can be challenging if you opt for a telemedicine solution that doesn’t integrate with your EHR. You would have to manually enter the information after every visit, meaning you’d waste valuable time on tedious, and unnecessary administrative tasks.

We understand how valuable healthcare professionals’ time is, so we’ve made an effort to ensure that Curogram integrates with over 700 EHRs. This frees up doctors’ time and allows them to treat more telemedicine patients daily.

Curogram EHR integrations

eClinicalWorks

Athena

Epic

Cerner

DrChrono

NextGen

Practice Fusion

CareCloud

Kareo

OfficeAlly

See More Integrations Here

Telemedicine reimbursement in New York

Regarding reimbursement, all telehealth and telemedicine services provided are considered the same as face-to-face services. Under New York’s parity law, private health plans cannot exclude telehealth coverage if the services delivered remotely would be covered if they were delivered in-person.

NYS Medicaid provides reimbursement to all eligible practitioners delivering remote care to Medicaid members for all three telehealth modalities—telemedicine, store-and-forward, and remote patient monitoring. 

New regulations and amendments in the face of COVID-19 emergency

The COVID-19 pandemic prompted new emergency regulations by the New York State Department of Financial Services (DFS). The goal was to encourage New Yorkers to seek medical aid through telehealth whenever possible for the duration of the COVID-19 emergency. To do so, the new regulation imposed by the DFS requires insurance companies to waive cost-sharing for telehealth visits, regardless if they’re related to COVID-19 or not.

For the duration of the pandemic, the NYS Medicaid will lift the restriction regarding phone consultations and will reimburse telehealth providers for audio-only health services as well. Medicaid will also cover all services without copays in the event that the purpose of the visit is COVID-19 testing. 

The New York State Department of Health (DOH) took action to promote the utilization of telehealth services in the face of the COVID-19 outbreak. DOH has also proposed that Home and Community Based Services provided under both the Home Health Care Management and 1915(c) Children’s Waiver be delivered via telehealth or telephonically whenever possible, to avoid unnecessary face-to-face contact.

Have a successful telemedicine start in New York with Curogram

New York law embraces telehealth and telemedicine as a way of providing medical care remotely. In the face of the COVID-19 emergency, relevant agencies outlining telehealth regulations also encourage healthcare providers to adopt telehealth as an alternative to in-person visits. 

That said, keep in mind that NYS telehealth policies aren’t the only thing you need to consider if you want to include remote visits in the services your practice offers. You can’t simply go for the first telehealth solution you come across. It’s also necessary to ensure that the solution you opt for enables you to stay fully HIPAA compliant while practicing telehealth and telemedicine.

That’s why Curogram is the perfect solution. Our telemedicine platform has all the necessary built-in HIPAA safeguards and allows you to provide remote services in a secure, 100% HIPAA compliant environment. 

Apart from that, you should also think about the efficiency and functionality of a telemedicine solution to ensure it satisfies the needs of your practice and your patients. That’s why we’ve made Curogram:

  1. Easy for doctors and medical staff to use
  2. Easy for patients to use

Easy for doctors and medical staff to use

With Curogram, you can take care of all telemedicine-related tasks from a single, browser-based dashboard. You can create virtual clinics, send appointment reminders to patients, initiate video calls, communicate with your colleagues, and share PHI on the platform

The best part about Curogram is that it mimics in-person workflows you and your employees are used to. Patients enter the waiting room and are prepared for the appointment by the medical staff, while the doctors take care of treating the patients without having to worry about intake forms or any other administrative tasks. This allows each doctor to admit more patients daily, increasing the revenue you get from incorporating telehealth and telemedicine services. 

Easy for patients to use

When thinking about a telemedicine solution, you have to look at it from both angles—how your practice will use it, and how patients will interact with it. Convenience is the key here, so you want to avoid complex applications with multi-step signup processes that will make patients less keen to attend the virtual appointments.

Curogram is extremely straight-forward. The patients will receive a text message from the local number associated with your practice’s Curogram account, with the link to attend the online appointment. The link will redirect them to your virtual clinic’s waiting room, where your medical staff can prepare them for the visit before an available doctor initiates the video call.

Following the visit, they’ll receive an SMS with a link to download the Curogram patient app where they can access the visit summary and other relevant medical information.

Partner up with us today and ensure a successful telemedicine start with Curogram

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, new york

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