Specifically, the legislation requires that health benefits plans reimburse providers for telehealth and telemedicine services at the same rate as in-person services.  However, there are limited exceptions which include a carve-out for healthcare services provided by a telemedicine or telehealth organization that are not also available through that organization on an in-person basis.

Additionally, A5757 only provides for a one-year extension of the original COVID-19-born legislation and will expire on December 31, 2024.  Any future extensions will likely be predicated on a review of a Department of Health study that is currently underway regarding the utilization of telehealth and telemedicine and its effects on patient outcomes, quality and satisfaction, and access to care. The goal of the one-year extension is to provide lawmakers with the time to review the result of the study and make informed recommendations moving forward.

As one might expect, there is groundswell of support for legislation promoting telehealth and telemedicine.  According to the Centers for Disease Control and Prevention, telehealth and telemedicine are effective approaches to ensuring services are available to those who live in rural areas and the efficient monitoring of patients with chronic conditions.  As such, even a one-year extension to the pandemic-era legislation is welcome news for telemedicine and telehealth companies for the time being.

(This blog, prepared by Campanella Law Office, is for general informational purposes only and is not intended to convey specific legal advice, nor is it intended to create or constitute an attorney-client relationship.)

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Effective October 2, 2023, the amendments to the regulations governing healthcare provider licensure by endorsement allow the Board to issue a license to an applicant if it determines that the state in which the applicant is licensed has standards for licensure substantially equivalent to New Jersey standards and the applicant has been practicing for at least two years within the five-year period prior to applying for a license.

Of course, applicants will have to show that relevant licenses are in good standing, undergo a criminal background check and designate a New Jersey statutory agent if they, themselves do not live or have offices in New Jersey.

The new rules also make it easier for individuals to reactivate or reinstate their licenses.  Applicants for renewal shall submit a renewal fee, information related to previous employment while inactive, and evidence of completing the continuing education credits required for the current renewal period.  Reinstatement applicants will be required to submit the same information but must also submit any past due fee from the last renewal period.

However, the new rules allow licenses to satisfy the continuing education requirements by submitting proof of compliance with another state’s continuing education requirements.  Thereafter, only if the Board concludes that an applicant would not be able to practice safely, they could still require them to pass an examination, complete a refresher course, or meet any other NJBOE-imposed requirement deemed necessary.

(This blog, prepared by Campanella Law Office, is for general informational purposes only and is not intended to convey specific legal advice, nor is it intended to create or constitute an attorney-client relationship.)

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On February 17, 2023, the U.S. Department of Health and Human Services Office for Civil Rights (OCR) shared two Reports to Congress for 2021 on HIPAA Privacy, Security, and Breach Notification Rule Compliance  and Breaches of Unsecured Protected Health Information.  The purpose of supplying this information was to assist in the compliance efforts of covered entities by sharing data regarding potential violations and the steps that were taken to investigate those complaints as they relate to current HIPAA rules and regulations.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was established to create federal protections for maintaining the privacy and security of protected health information (PHI) and give individuals rights with respect to the disclosure of that information. However, according to the reports, there have been significant increases in HIPAA complaints and large breaches reported from 2017-2021.  To address areas of concern, the reports include specific information relating to:

• Numbers of HIPAA cases investigated and the methods by which they were resolved.
• Numbers of reported breaches of unsecured protected health information and action steps taken in response to those breaches.
• Areas in need of improvement such as risk analysis and risk management.

Overall, despite reporting steps already taken to increase public outreach and awareness, the reports recommend that additional strategies are necessary to improve compliance with HIPAA.

Campanella Law Office recognizes the importance of patience privacy and offers a complimentary on-line HIPAA risk assessment through its strategic partner, The Garlick Group.

Campanella Law Office also offers a package of services to ensure HIPAA compliance.  If you would like assistance reviewing your HIPAA compliance procedures or have any questions related to the protection of protected health information, contact us.

The post HHS Reports on HIPAA Compliance and Areas That Need Improvement appeared first on Campanella Law Office.

On December 27, 2020, H.R. 133 (116th), better known as the Consolidated Appropriations Act, 2021, was signed into law.  Included therein, was a key consumer protection law designed to shield patients from receiving unexpected, and often exorbitant, out-of-network medical bills.  Effective as of January 1, 2022, the No Surprises Act (the “NSA”) provides patients with federal protections against balance billing; specifically requiring private health insurance companies to cover certain out-of-network bills and prohibiting providers from billing patients more than they would have to pay for in-network care.

Key provisions of the NSA include:

• The requirement that insurers who cover emergency services bill plan holders no more than the median in-network rate for a particular service, even if the provider is out-of-network; ensuring that most emergency care is covered as if it were in-network without any requirement for prior authorization.
• A restriction on balance billing for non-emergency services to only those circumstances where the out-of-network provider has complied with specific notice and consent requirements and was not the only provider available to deliver care at the particular in-network facility.
• A requirement that facilities and providers give patients notices explaining, and publicly post, applicable billing protections and grievance procedures.
• A requirement that uninsured patients receive important information that includes a good-faith estimate of costs before being provided non-emergency care.

While the new legislation may provide much-needed security for patents seeking emergency care, providers should know that failure to abide by the NSA can result in some hefty penalties.  As a result, providers should make it a priority to review and revise their billing practices and post all notices relevant to surprise billing.

Additional information, including detailed balance billing rules and standard notice and consent forms, can be found on the United States Centers for Medicare & Medicaid website.

Our Principal Attorney will be hosting a free webinar on this topic on Wednesday, January 19, 2022 at 12:30PM.   Register for the webinar here!

If you have questions about the No Surprises Act and how it affects you or your health care facility, Contact Us.

The post No Surprises Act: What Providers Should Know About the New Patient Protection Legislation appeared first on Campanella Law Office.

On July 13, 2021, the New Jersey Department of Health (DOH) adopted new regulations that require all telemedicine and telehealth organizations providing services in New Jersey to submit a registration application before October 15, 2021.   The newly codified Registration Standards for Telemedicine and Telehealth Organizations (N.J.A.C. 8:53) implement certain provisions of the 2017 New Jersey Telemedicine and Telehealth Act (N.J.S.A. § 45:1:61 et seq.).

Affected entities include organizations whose primary purpose is the administration of services in furtherance of telemedicine or telehealth.  Healthcare facilities who provide in-person services and merely use telemedicine or telehealth in addition to in-person evaluations, are not subject to the new provisions.  Those who fail to register by October 15, 2021, will face enforcement actions which include monetary penalties or suspension.  Thereafter annual registration and fees are required and any changes to information provided on licensure applications must be reported within five business days of the change through an amended application.

You can find more information on New Jersey’s Telemedicine and Telehealth Organization Registry website.    Meanwhile, if you have any questions about the new telemedicine and telehealth registration requirements, Contact Us.

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