Lawsuit Alleges New Jersey’s Telemedicine Licensing Regulations Impede Access to Treatment

Overview:

  • Patients of two doctors, an oncologist and a neurologist, have sued the New Jersey State Medical Examiner’s Office, claiming that the state’s telemedicine physician licensing requirements limit their access to potentially life-saving specialty care.
  • A lawsuit filed last week in U.S. District Court in New Jersey details two young patients who were able to receive telehealth consultations and follow-up care from out-of-state doctors after being diagnosed with a rare brain tumor. The requirement is that doctors must be licensed in New Jersey to practice telemedicine.
  • The lawsuit comes as relaxed rules on interstate licensing adopted during the COVID-19 pandemic begin to expire, which advocates argue could prevent patients from getting the care they need.

Insights:

During the pandemic, New Jersey relaxed the requirement that providers be licensed in the state to provide virtual care, allowing patients to see out-of-state doctors via telehealth if they have a pre-existing relationship. The state also “streamlined” the licensing process, waiving fees and allowing doctors to become licensed within 24 hours of applying, according to the lawsuit.

But that flexibility expired at the end of March. Now, the standard state licensing process can take significant documentation and months to process, the doctors who filed the suit claim.

Experts argue they have the expertise that patients across the country want, especially when local doctors don’t have the resources or experience to treat their conditions.

However, obtaining and maintaining multiple state licenses with different requirements and deadlines can be challenging for providers, and patients cannot easily travel for consultations and follow-up appointments they may need.

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“Without telemedicine, the cost and time required to physically travel to each specialist’s office for a consultation would prevent most patients from receiving important care,” the lawsuit states. “Furthermore, without an opportunity for an initial consultation, a patient’s health condition may prevent them from traveling even if they can afford it.”

One plaintiff in the lawsuit was diagnosed with pineoblastoma, a rare brain tumor, at 18 months old. When high-dose chemotherapy and two surgeries at their home hospital in New York didn’t work, the family spoke via telemedicine with a radiation oncologist in Massachusetts. Plaintiff traveled to Boston for treatment and was able to receive virtual follow-up appointments to monitor his recovery.

The second plaintiff was diagnosed with craniocervical junction chordoma, a large tumor at the base of the skull, at age 19. He was also able to consult remotely with an out-of-state physician, relocate to receive treatment, and later conduct follow-up appointments via telehealth.

Without access to out-of-state providers, patients may have to rely on local clinicians who have no experience with rare diseases, the lawsuit said. Patients like the two plaintiffs also require long-term monitoring to prevent their cancer from returning. — This can be difficult if you have to constantly travel to review scans and discuss results with your doctor.

The lawsuit comes as lawmakers consider making permanent telehealth flexibilities introduced during the pandemic. At a hearing last month, senators showed bipartisan support for tweaks to the Medicare program, such as allowing visits outside rural areas or virtually prescribing some controlled substances, such as those for treating opioid use disorder.

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