www.njchiropractors.com I 7 Q Can a chiropractor in New Jersey own a practice with or employ a physical therapist? A In New Jersey, chiropractic practice structure is governed by the “Permissible Practice Structure Regulations” contained in Title 44E of the New Jersey Administrative code as well as case law and attorney general advisories that have addressed practice structure. The physical therapy regulations are silent as to permissible practice structures at present. In general, a Doctor of Chiropractic (“DC”) and a Physical Therapist (”PT”) are considered “closely allied healthcare providers” and may practice together provided their association is structured compliantly. If the DC and PT are co-shareholders in a professional corporation or limited liability company, the DC must have a majority of ownership interest as a chiropractic license is considered of higher scope than a PT license under controlling law. A DC is also permitted to hire a PT under a traditional employer/employee relationship and bill for their services as an employee under the same analysis. However, a PT could not employ a DC as a person of lower licensure cannot employ a person of higher licensure (i.e. a PT cannot employ a DC and a DC cannot employ an MD). Q Is the practice of telemedicine permitted in New Jersey where I can consult with the patient via Skype or other electronic method? A Yes, the New Jersey Legislature passed a law in August 2017 which permits licensed healthcare providers in New Jersey to perform telemedicine provided they meet certain criteria spelled out in the law. “Telemedicine,” as defined by the law, means the delivery of a healthcare service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a healthcare provider who is located at a distant site and a patient who is located at an originating site, either with or without the assistance of an intervening healthcare provider. Telemedicine does not include the use, in isolation, of audio-only telephone conversation, electronic mail, instant messaging, phone text, or facsimile transmission. A healthcare provider may remotely provide healthcare services to a patient through the use of telemedicine. Healthcare providers may also engage in “telehealth” activities to support and facilitate the provision of healthcare services to patients, which means the use of information and communications technologies, including telephones, remote patient monitoring devices, or other electronic means, to support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulations that are to be adopted. Healthcare providers using telemedicine or telehealth are subject to the same standard of care or practice standards as are applicable to in-person settings. If telemedicine or telehealth services would not be consistent with this standard of care, the provider must direct the patient to seek in-person care. Q What types of telemedicine services are allowed in New Jersey and are they reimbursable under health plans? A A healthcare provider engaging in telemedicine or telehealth may use asynchronous store-and-forward technology to allow for the electronic transmission of images, diagnostics, data, and medical information. However, a provider may use interactive, real- time, two-way audio in combination with asynchronous store-and-forward technology, without video capabilities if, after accessing and reviewing the patient’s medical records the provider determines that they are able to meet the same standard of care as if the health care services were being provided in person. Medicaid, NJ Family Care, and certain health insurance providers, including the carriers of health benefits plans for the State Health Benefits Commission, and the School Employees’ Health Benefits Commission, are mandated to provide coverage and payment for services provided through telemedicine and telehealth on the same basis as, and at a provider reimbursement rate that does not exceed the provider reimbursement rate that is applicable, when the services are delivered in-person in New Jersey. Jeffrey Randolph, Esq. (the author of Legal Ease and Legal Q&A) is an independent person of the ANJC and his views are not authorized, sponsored, or otherwise approved by the ANJC. The information provided is for general guidance on matters of interest only and may not take into account particular facts relevant to your individual situation. The application and impact of laws and health care can vary widely based on the specific facts involved. Given the changing nature of laws, rules and regulations, there may be omissions or inaccuracies in information contained in these materials. Accordingly, the information you receive is provided with the understanding that the author and the ANJC are not herein engaged in rendering legal, accounting, tax, health care or other professional advice and services nor are they providing specific advice with regard to your practice, the treatment of any specific illness, disease, deformity or condition, or any other matter that affects trade, commerce, or legal rights of others. As such, this article should not be used as a substitute for consultation with professional accounting, tax, legal, health care, or other competent advisers. Before making any decision or taking any action, you should consult an appropriately trained professional. Medicare Q&A Medicare Update Legislative Update LEGAL Q&A Executive Director’s UPDATE ate INSURANCE Update By Jeffrey Randolph ANJC Legal Counsel