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  • NJ S291
  • Authorizes health care providers to engage in telemedicine and telehealth.*
In Committee
Crossed Over
Dead/Failed/VetoedVeto Overridden
2016-2017 Regular Session
This bill would authorize health care practitioners in the State - including physicians, nurse practitioners, psychologists, psychiatrists, psychoanalysts, licensed clinical social workers, physician assistants, and any other health care professional acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes - to deliver health care services, and establish a practitioner/patient relationship, through the use of telemedicine. This authorization would extend to mental health screeners, who, as specified by the bill, would be allowed to engage in mental health screening procedures through telemedicine without necessitating a waiver from existing rules. "Telemedicine" is defined by the bill to mean the delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between the health care practitioner who is located at one site, and a patient who is located at a different, remote site, either with or without the assistance of an intervening health care provider, and which typically involves the provision of health care services through the application of secure, two-way videoconferencing or store-and-forward technology that is designed to replicate the traditional in-person encounter and interaction between health care practitioner and patient by allowing for interactive, real-time visual and auditory communication, and the electronic transmission of images, diagnostics, and medical records. "Telemedicine" would not include the use of audio-only telephone conversation, electronic mail, instant messaging, phone text, or facsimile transmission. Pursuant to the bill's provisions, the delivery of health care services through the use of telemedicine would be subject to the same standards of care and rules of practice as are applicable to traditional in-person practice, and the use of telemedicine would not reduce or eliminate any existing duty or responsibility of the health care practitioner, or any assistant thereof, including any duty or responsibility related to recordkeeping or the maintenance of patient confidentiality. Any health care practitioner who engages in telemedicine without complying with the ordinary standards of care or rules of practice applicable to in-person practice would be subject to discipline by the respective licensing board, as provided by law. The bill would authorize an out-of-State health care practitioner to engage in telemedicine with patients in this State, but only pursuant to a reciprocal medical practice (or other appropriate practice) license. Existing law at N.J.S.A.45:1-7.5 - which was enacted in 2013 and became effective on July 1, 2014 - already provides that a reciprocal license must be granted to any out-of-State health care practitioner, upon application therefor, if: (1) the other state has substantially equivalent requirements for licensure, registration, or certification; (2) the applicant has practiced in the profession within the five-year period preceding application; (3) the respective New Jersey State board receives documentation showing that the applicant's out-of-State license is in good standing, and that the applicant has no conviction for a disqualifying offense; and (4) an agent in this State is designated for service of process if the non-resident applicant does not have an office in this State. Consistent with the provisions of N.J.S.A.45:1-7.5, this bill would amend the individual practice laws pertaining to the reciprocal licensure (or licensure by indorsement) of physicians, nurse practitioners, social workers, psychologists, psychoanalysts, and physician assistants - which, in most cases, currently provide only for discretionary reciprocal licensure - in order to clarify that a reciprocal license: (1) must be granted if the conditions established by N.J.S.A.45:1-7.5 are satisfied; and (2) may still be granted, in the discretion of the respective licensing board, in cases where those statutory conditions are not satisfied. In addition to clarifying the existing State law that pertains to the reciprocal licensing of health care practitioners, the bill would also require the Board of Medical Examiners to evaluate the interstate Telemedicine Licensure Compact that is currently being promoted by the Federation of State Medical Boards, and which, if adopted, would establish a universally-accepted and more simplistic system of reciprocal licensing for physicians. Within 180 days after the bill's effective date, the board would be required to submit to the Governor and Legislature, a report of its findings on the matter, and recommendations for legislation or other State action necessary to implement the compact in this State. In order to facilitate the use of telemedicine in this State, and except when contrary to federal or State law, the bill would prohibit the State Medicaid and NJ FamilyCare programs, as well as any private health benefits plan - including those provided by private carriers, and those contained in contracts purchased by the State Health Benefits Commission and the School Employees' Health Benefits Commission - from requiring in-person contact between a health care practitioner and a patient, or from establishing any siting or location restrictions on a health care practitioner or a patient, as a condition of reimbursement under the respective program or plan. The bill would further require such programs and plans to provide coverage and reimbursement for: (1) health care services that are delivered through telemedicine, to the same extent, and at the same reimbursement rate, that such services are covered and reimbursed when provided in-person (so long as the use of telemedicine is not medically contraindicated), and (2) any professional or facility fees that may be associated with the delivery of covered services through telemedicine, so long as such fees would otherwise be eligible for coverage or reimbursement in the case of in-person service delivery. Finally, the bill would specify that a health care practitioner may engage in consultations with out-of-State peer professionals, including, but not limited to, a sub-specialist, using electronic or other means, without obtaining a separate license or authorization therefor. In addition to the substantive changes described above, the bill would incorporate a number of technical and stylistic changes to the existing laws that govern the practice of various types of health care practitioners, as is necessary to both accomplish the bill's purposes and enhance clarity and readability in these areas. In particular, the bill would: (1) redefine various statutory terms and revise various statutory provisions that are used to delineate the scope of practice for various health care practitioners, in order to expressly include telemedicine as an acceptable means or method of practice and service delivery; (2) update language contained in relevant sections of Title 45 of the Revised Statutes, in order to reflect the changes that have been made by the bill; (3) ensure that the laws being amended by the bill contain modern language, avoid the use of archaic or redundant terminology, use language consistently from section to section, and conform to modern tenets of statutory drafting (including, for instance, the tenet that provides for the alphabetization of definitional terms); (4) consolidate two existing sections of law (R.S.45:9-18 and R.S.45:9-18.1) that are used to help define both the "practice of medicine" and the unauthorized practice thereof, but which are presently allocated separately from other similar provisions of law, and incorporate these provisions into a more logical and cohesive statutory location - in particular, into the existing statutory definitions and sections of law that outline the parameters of acceptable medical practice; (5) repeal the existing sections of law being consolidated; and (6) eliminate certain provisions of law which are applicable to a class of people who are no longer practicing (specifically, persons who matriculated in college prior to 1935 and persons who were practicing medicine before July 4, 1890).
2nd Reading in the Senate, Bills and Joint Resolutions Signed by the Governor, Budget and Appropriations, Health, Human Services and Senior Citizens, Passed both Houses
Approved P.L.2017, c.117.  (on 7/21/2017)
Date Chamber Action Description
7/21/2017 A Approved P.L.2017, c.117.
6/22/2017 A Passed Assembly (Passed Both Houses) (73-0-0)
6/22/2017 A Substituted for A1464 (ACS/1R)
6/22/2017 A Received in the Assembly without Reference, 2nd Reading
6/22/2017 S Passed by the Senate (38-0)
6/19/2017 S Senate Substitution (31-0) (Vitale)
11/3/2016 S Reported from Senate Committee as a Substitute, 2nd Reading
11/3/2016 Senate Budget and Appropriations Hearing (13:00 11/3/2016 Committee Room 4, 1st Floor)
9/26/2016 S Referred to Senate Budget and Appropriations Committee
9/26/2016 S Reported from Senate Committee as a Substitute, 2nd Reading
9/26/2016 Senate Health, Human Services and Senior Citizens Hearing (13:00 9/26/2016 Committee Room 1, First Floor)
1/12/2016 S Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee
Date Motion Yea Nay Other
Detail 6/22/2017 Assembly Floor: Third Reading - Final Passage 73 0 7
Detail 6/22/2017 Assembly Floor: Substitute For A1464 Acs (Voice Vote) 0 0 0
Detail 6/22/2017 Senate Floor: Third Reading - Final Passage 38 0 2
Detail 6/19/2017 Senate Floor: Senate Substitute 31 0 9
Detail 6/19/2017 Senate Floor: Second Reading (Voice Vote) 0 0 0
Detail 11/3/2016 Senate Budget and Appropriations Committee: Reported with Substitution 13 0 0
Detail 9/26/2016 Senate Health, Human Services and Senior Citizens Committee: Reported with Substitution 9 0 0