Telehealth Essentials: A New Jersey Guide
June 29, 2020
Originally posted: 3/24/2020
We recognize that this is a complex issue for providers and patients alike. We are currently gathering information relating to telehealth, including links to carriers’ policies, to help you during this time.
Check back regularly for updates.
Policy Guidance
State Guidance: On March 22, the Governor announced a variety of departmental actions that will clear the way for services to be provided via telehealth. This action will allow for therapist/providers to be reimbursed by insurance carriers for services offered remotely. In doing so, it will allow essential behavior, speech, and other related services to resume/continue while adhering to the order to stay home.
Federal Guidance: Also, on March 13, the U.S. Department of Health & Human Services relaxed their enforcement of HIPAA-related requirements and issued the following guidance: Notification of Enforcement Discretion for Telehealth. This notification includes telehealth platforms to consider. (Note: Scroll down the page to view guidance if it isn’t immediately apparent)
See also: HHS Issues Section 1135 Waiver, and CMS Issues Blanket Waivers of Health Care Laws, in Response to Coronavirus (COVID-19) Emergency from The National Law Review for more information.
Carrier Guidance
- United/Optum: COVID-19 updates to telehealth policies for ABA services
- Amerihealth: AmeriHealth New Jersey response to COVID-19
- Cigna: Interim Telehealth Guidance
- Tricare: Tricare Telehealth Support for ABA
- Horizon: Horizon Telehealth and Behavioral Continuity Guide
- Although Horizon’s Telehealth and Behavioral Continuity Guide states that ABA services provided via telehealth are reimbursable through June 30th, recent guidance states that this benefit is extended through the end of the public health emergency.
- Aetna: Aetna’s website confirms that the no-cost benefit applies to telemedicine visits for behavioral health. Additionally, it clarifies:
- Regulations regarding telehealth services and care package availability for Aetna Medicaid members varies by state and, in some cases, are changing in light of the current situation. Aetna Medicaid members with questions about their benefits are encouraged to call the member services phone number on the back of their ID cards.
- Approved Behavior Health Telemedicine Services
Resources for Providers
Additionally, the following information and links may be helpful for providers adapting to this new service.
- ABA Billing Codes Commission’s list of funding sources authorizing telehealth
- Practice Brief: Telehealth and the Practice of Applied Behavior Analysis (ABA) (CalABA)
- Telehealth and Crisis Management Guidelines (Council of Autism Service Providers)
- Telepractice of ABA During the Pandemic (APBA webinar; free for members)
- A Proposed Process for Risk Mitigation During the COVID-19 Pandemic (Click the link and then “Download preprint;” pending publication in the journal, Behavior Analysis in Practice)
- Maximizing Parent Participation During Telehealth Services (Rethink)
Out-of-Network Services
Even during this crisis, out-of-network providers may not be approved to deliver medically necessary services. In emergent and otherwise critical situations, such providers may wish to consider talking to their clients and their insurance carriers about requesting what’s called an “in-network exception” or a “single case agreement” to become approved to provide services via telehealth.
Experience Our Power of Connection
Autism New Jersey will continue to follow recommendations from the CDC and state Department of Health as the state begins to move through the stages of reopening.
We’re proud to say that not one call to our Helpline has gone unanswered. If you need assistance, call us at 800.4.AUTISM or information@autismnj.org or send us a message/chat with us via the link at the bottom of this page.
We remain focused on our mission to be a resource for the autism community. We recognize that there are many questions and complex considerations, and we are working hard to address these substantial issues and provide our expertise and stakeholder perspectives as plans are developed. We encourage you to regularly visit our central hub of coronavirus resources for the autism community.