Telehealth Essentials: A New Jersey Guide
March 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
We are working to get clarification from funders and, once we do, we will post in this section.
- 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 Updates
- 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)
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 is following recommendations from the CDC and state Department of Health and is implementing telework and remote meetings for its employees to help reduce the community spread of the coronavirus.
During this time, our 800.4.AUTISM Helpline will remain open. Please leave a message with specific dates and times you are available for a call-back, or email information@autismnj.org. You can also message us via our website, and we’ll aim to reply promptly.
We remain focused on our mission to be a resource for the autism community. With a fluid situation and great uncertainty, we’ll share relevant, accurate information as it becomes available. We encourage you to regularly visit our central hub of coronavirus resources for the autism community.