NJSHA’s Response to COVID-19: Updates and Resources

General Information |New Jersey Legislative Updates | NJ School Settings | NJ Early Intervention Professional | Higher Education Issues/Clinical Supervision | NJ Private Practice and Health Care Issues | Resources

General Information

Information continues to change daily. If you are having concerns about COVID-19 and seeing patients contact the local board of health in the town your facility is located.

New Jersey Legislative Updates

Twenty-three bills were introduced in NJ and quickly moved through both houses of the Legislature to address COVID-19. NJSHA and our lobbyist have been monitoring these bills and proposing amendments where appropriate. We have also been connecting to relevant state agencies, including the Department of Education (DOE) and the Department of Health (DOH) about issues related to these pieces of legislation and ways that NJSHA members can continue to provide services to our students and patients during these unprecedented times.

Private Practice and Health Care Settings
NJ Legislation
A3843 / S2283, McKeon (D-Essex)/ Vitale (D-Middlesex) – Requires health insurance and Medicaid coverage for testing of coronavirus disease 2019 and for telemedicine and telehealth during coronavirus disease 2019 state of emergency.

https://www.njleg.state.nj.us/2020/Bills/A4000/3843_S1.PDF

Signed into law, P.L. 2020, c. 7.

As originally introduced, this bill only required coverage of the virus testing but telehealth was added on the Assembly floor on Mon, March 16. The bill states that the coverage of telehealth shall be in accordance with the provisions of P.L. 2017, c. 117, legislation that governs telemedicine/telehealth in the state. NJSHA was involved in the process that led to creation of that law, including the explicit inclusion of audiologists and speech therapists.

NONE of the NJ legislation related to telehealth applies to self-funded/ERISA plans.  This starts with P.L. 2017, c. 117 and continues through A3843.  Under no circumstances can NJ law cover self-funded plans because of federal preemption.  The Self-funded plans may choose to do what is applied to fully-funded plans but they are not obligated to do so.  FURTHER, if a plan offered by an employer (fully funded) does not cover a certain service (let’s say speech therapy or PT or whatever), the telemedicine/telehealth-in person equal coverage mandate in P.L. 2017, c. 117 does not apply.  Essentially, you can’t “back in” to getting a certain service covered under telemedicine/telehealth if it was not already covered.

What does this mean for you? It means that any fully funded plan in NJ must cover speech therapy and audiology services during this state of emergency.

A3860 / S2289 , Pinkin (D-Middlesex)/ Vitale (D-Middlesex) – Establishes certain requirements to use telemedicine and telehealth to respond to coronavirus disease 2019 (COVID-19).

https://www.njleg.state.nj.us/2020/Bills/A4000/3860_I1.PDF

Signed into law March 19. P.L. 2020, c. 3.

What does this mean for you? This bill does a few things. It allows a licensed practitioner to provide and bill for telehealth even if rules for their particular practice have not yet been adopted (NOTE: THIS IS VERY IMPORTANT FOR SPEECH AND AUDIOLOGY: WHILE THE AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY LICENSING COMMITTEE PROPOSED THE RULES FOR THE TWO PROFESSIONS– AND NJSHA COMMENTED ON THEM – THEY HAVE NOT BEEN FORMALLY ADOPTED). It also allows an out of state provider to provide telehealth but only related to testing and treatment of COVID -19 unless the provider had a previous relationship with the patient. It allows the DOH to waive privacy requirements.

It removes any regulatory barriers that might exist and allows you to provide teletherapy services as per A3483. It would allow a licensed SLPs/Audiologist from another state to provide teletherapy to a NJ resident, if that therapist has a pre-existing professional relationship with the patient.

Professional and Licensing Boards

A3862 / S2298, Giblin (D-Essex)/ Pou (D-Passaic) – Permits professional and occupational licensing boards to expedite licensure of certain individuals during state of emergency or public health emergency.

https://www.njleg.state.nj.us/2020/Bills/A4000/3862_I1.PDF

Signed into law March 19, 2020

What does this mean for you? It removes the barrier for criminal history checks checks and other delays in order to expedite new licenses.

March 22, 2020 – Governor Murphy Announces Departmental Actions to Expand Access to Telehealth and Tele-Mental Health Services in Response to COVID-19

Bill A3904 has been signed into law as of 4.14.20. This law “Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.”

What does this mean for you? This law permits speech-language services to be delivered to students with disabilities through the use of electronic communication or a virtual or online platform and as required by the student’s Individualized Education Program (IEP), to the greatest extent practicable.

View current version of bill

Update April 13, 2020

Bill A3904, was presented to as S-2337 from the Senate floor. It passed the Senate 37-0 along with a 2nd reading in Assembly to concur with Senate amendments then passed the Assembly 80-0-0. It has now been sent to the Governor. This bill “Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.”

What does this mean for you? If the A3904/Bill S 2337 is signed into law by the Governor, speech-language services will be permitted to be delivered to students with disabilities through the use of electronic communication or a virtual or online platform and as required by the student’s Individualized Education Program (IEP), to the greatest extent practicable.

View current version of bill

Update from NJDOE on April 1, 2020

On April 1, 2020 the NJ Department of Education passed a ruling to allow the use of telepractice to provide related services within the schools. The Notice of Rule Waiver/modification/Suspension which states, “The opportunities provided to students with disabilities shall be consistent with the student’s IEP to the greatest extent possible. Further, during an extended public health-related school closure, related services to students with disabilities shall be provided through electronic communications, virtual, remote, or other online platforms, as appropriate and as required by the student’s IEP to the greatest extent possible.” Notice of Rule Waiver/modification/suspension Approved April 1, 2020.

What does this mean for you?
This means NJ SLSs will likely be directed by administration to begin telepractice services. SLSs should work with the guidelines set forth by their district with regard to secure platforms, documentation, billing, and parental consent and involvement. If you have never done teletherapy before, there are now many free resources online such as webinars and free materials to get you started. NJSHA will continue to reach out to the NJ DOE- Office of Special Education with members continued concerns as we navigate these uncharted waters.

NJSHA SAC is working closely with the Legislative Committee to provide an FAQ sheet together as more information becomes available.

Update from NJDOE on March 30, 2020

On April 1, the New Jersey State Board of Education plans to pass an emergency resolution that will temporarily allow telepractice for the schools to ensure that special education students have access to related services and therapies as designated in their IEPs. Notice of Rule Waiver/modification/suspension. Check back on April 1 for more information.

A3904, Burzichelli (D-Gloucester)/– Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.

https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.PDF
https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.HTM

Update March 25, 2020

A new bill, A3904, which is a replacement for bill A3813, was introduced to address some needed changes to the legislation. The Assembly held a virtual session and A3904 passed unanimously. Speech-language services are still explicitly included in the new bill. We are awaiting an announcement regarding a Senate session as they will need to act on the legislation before it goes to the Governor for signature.

What does this mean for you? If the A3904 bill is signed into law, this will allow use of telepractice for the provision of related services, including speech, for the schools. It would be the district’s responsibility to provide a platform that is FERPA compliant.

Replaced by bill A3904 on March 23, 2020 for A3813

Background information:
An August 2019 memo from the NJ DOE to all school districts issued a ban on the use of telepractice for the provision of related services, including speech. NJSHA largely supported this prohibition as it arose from abuse in certain school districts. However, with the closure of schools due to the crisis, this document was an impediment to SLSs being able to utilize telepractice to provide virtual services, when appropriate. Led by members of NJSHA School Affairs Committee and working with our lobbyist, NJSHA reached out to the DOE and also the DOH to see if the memo would be temporarily halted. We were told that it would not be. The A3904, Burzichelli (D-Gloucester) would permit use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances, which would include speech-language services.

Update March 26, 2020

A3904, Burzichelli (D-Gloucester)/– Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.

https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.PDF
https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.HTM

ALERT-UPDATE 3.25.20: A new bill, A3904, which is a replacement for bill A3813, was introduced to address some needed changes to the legislation. The Assembly held a virtual session and A3904 passed unanimously. Speech-language services are still explicitly included in the new bill. We are awaiting an announcement regarding a Senate session as they will need to act on the legislation before it goes to the Governor for signature.

What does this mean for you? If the A3904 bill is signed into law, this will allow use of telepractice for the provision of related services, including speech, for the schools. It would be the district’s responsibility to provide a platform that is FERPA compliant.

Replaced by bill A3904 on 3.23.20 for A3813

Background information:
An August 2019 memo from the NJ DOE to all school districts issued a ban on the use of telepractice for the provision of related services, including speech. NJSHA largely supported this prohibition as it arose from abuse in certain school districts. However, with the closure of schools due to the crisis, this document was an impediment to SLSs being able to utilize telepractice to provide virtual services, when appropriate. Led by members of NJSHA School Affairs Committee and working with our lobbyist, NJSHA reached out to the DOE and also the DOH to see if the memo would be temporarily halted. We were told that it would not be. The A3904, Burzichelli (D-Gloucester) would permit use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances, which would include speech-language services.

Update March 23, 2020

A3813/S2292, Burzichelli (D-Gloucester)/Cardinale (R-Bergen) – Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances. This is no longer a viable bill. See A A3904 above.

A3842/S2281, Greenwald (D-Camden)/Ruiz (D-Essex) – Establishes Bridging the Digital Divide in Schools Grant Program in DOE to provide and expand access to technology and equipment for students in certain school districts.

https://www.njleg.state.nj.us/2020/Bills/A4000/3842_I1.PDF

Passed both houses, on the Governor’s desk.

What does this mean for you? This would provide extra funding to provide and expand access to technology and equipment for students in certain school districts to access remote learning.

Professional and Licensing Boards
A3862 / S2298, Giblin (D-Essex)/ Pou (D-Passaic) – Permits professional and occupational licensing boards to expedite licensure of certain individuals during state of emergency or public health emergency.

https://www.njleg.state.nj.us/2020/Bills/A4000/3862_I1.PDF

Signed into law March 19, 2020

What does this mean for you? It removes the barrier for criminal history checks checks and other delays in order to expedite new licenses.

NJ School Settings

On May 12, 2020, NJSHA participated in a meeting with the NJ Department of Education and other stakeholders to discuss teletherapy related topics. As a result of this meeting all those involved will be working collaboratively to establish discipline specific guidelines to offer NJ school districts regarding technology and best practices for conducting assessments and provision of therapy via teletherapy.

A follow up meeting will be held in approximately 2-3 weeks. NJSHA is grateful for this opportunity and looking forward to being able to, more completely, answer many of the questions pouring in from throughout the State. Please be patient and check back often for additional updates. In the meantime, please share with NJSHA any issues and concerns you may be experiencing in your districts, by writing, info@njsha.org, order for us to have a broader view in the schools.

Update May 4, 2020

New Jersey schools closed for rest of academic year, June 30, 2020.

State of New Jersey Department of Education: Parental Waivers for the Delivery of Remote or Virtual Special Education and Related Services

Update April 14, 2020

Bill A3904 has been signed into law as of 4.14.20. This law “Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.”

What does this mean for you? This law permits speech-language services to be delivered to students with disabilities through the use of electronic communication or a virtual or online platform and as required by the student’s Individualized Education Program (IEP), to the greatest extent practicable.

View current version of bill

Update April 13, 2020

Bill A3904, was presented to as S-2337 from the Senate floor. It passed the Senate 37-0 along with a 2nd reading in Assembly to concur with Senate amendments then passed the Assembly 80-0-0. It has now been sent to the Governor. This bill “Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.”

What does this mean for you? If the A3904/Bill S 2337 is signed into law by the Governor, speech-language services will be permitted to be delivered to students with disabilities through the use of electronic communication or a virtual or online platform and as required by the student’s Individualized Education Program (IEP), to the greatest extent practicable.

View current version of bill

Update from NJDOE on April 1, 2020

On April 1, 2020 the NJ Department of Education passed a ruling to allow the use of telepractice to provide related services within the schools. The Notice of Rule Waiver/modification/Suspension which states, “The opportunities provided to students with disabilities shall be consistent with the student’s IEP to the greatest extent possible. Further, during an extended public health-related school closure, related services to students with disabilities shall be provided through electronic communications, virtual, remote, or other online platforms, as appropriate and as required by the student’s IEP to the greatest extent possible.” Notice of Rule Waiver/modification/suspension Approved April 1, 2020.

What does this mean for you?
This means NJ SLSs will likely be directed by administration to begin telepractice services. SLSs should work with the guidelines set forth by their district with regard to secure platforms, documentation, billing, and parental consent and involvement. If you have never done teletherapy before, there are now many free resources online such as webinars and free materials to get you started. NJSHA will continue to reach out to the NJ DOE- Office of Special Education with members continued concerns as we navigate these uncharted waters.

NJSHA SAC is working closely with the Legislative Committee to provide an FAQ sheet together as more information becomes available.

Update from the NJ DOE March 30, 2020

On April 1, the New Jersey State Board of Education plans to pass an emergency resolution that will temporarily allow telepractice for the schools to ensure that special education students have access to related services and therapies as designated in their IEPs. Notice of Rule Waiver/modification/suspension. Check back on April 1st for more information.

A3904, Burzichelli (D-Gloucester)/– Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.

https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.PDF
https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.HTM

Update March 23, 2020

A new bill, A3904, which is a replacement for bill A3813, was introduced to address some needed changes to the legislation. The Assembly held a virtual session and A3904 passed unanimously. Speech-language services are still explicitly included in the new bill. We are awaiting an announcement regarding a Senate session as they will need to act on the legislation before it goes to the Governor for signature.

What does this mean for you? If the A3904 bill is signed into law, this will allow use of telepractice for the provision of related services, including speech, for the schools. It would be the district’s responsibility to provide a platform that is FERPA compliant.

Replaced by bill A3904 on March 23, 2020 for A3813

Background information:
An August 2019 memo from the NJ DOE to all school districts issued a ban on the use of telepractice for the provision of related services, including speech. NJSHA largely supported this prohibition as it arose from abuse in certain school districts. However, with the closure of schools due to the crisis, this document was an impediment to SLSs being able to utilize telepractice to provide virtual services, when appropriate. Led by members of NJSHA School Affairs Committee and working with our lobbyist, NJSHA reached out to the DOE and also the DOH to see if the memo would be temporarily halted. We were told that it would not be. The A3904, Burzichelli (D-Gloucester) would permit use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances, which would include speech-language services.

Update March 26, 2020

A3904, Burzichelli (D-Gloucester)/– Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances.

https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.PDF
https://www.njleg.state.nj.us/2020/Bills/A4000/3904_I1.HTM

Update March 23, 2020

A new bill, A3904, which is a replacement for bill A3813, was introduced to address some needed changes to the legislation. The Assembly held a virtual session and A3904 passed unanimously. Speech-language services are still explicitly included in the new bill. We are awaiting an announcement regarding a Senate session as they will need to act on the legislation before it goes to the Governor for signature.

What does this mean for you? If the A3904 bill is signed into law, this will allow use of telepractice for the provision of related services, including speech, for the schools. It would be the district’s responsibility to provide a platform that is FERPA compliant.

Replaced by bill A3904 on March 23, 2020 for A3813

Background information:
An August 2019 memo from the NJ DOE to all school districts issued a ban on the use of telepractice for the provision of related services, including speech. NJSHA largely supported this prohibition as it arose from abuse in certain school districts. However, with the closure of schools due to the crisis, this document was an impediment to SLSs being able to utilize telepractice to provide virtual services, when appropriate. Led by members of NJSHA School Affairs Committee and working with our lobbyist, NJSHA reached out to the DOE and also the DOH to see if the memo would be temporarily halted. We were told that it would not be. The A3904, Burzichelli (D-Gloucester) would permit use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances, which would include speech-language services.

Update March 23, 2020

A3813/S2292, Burzichelli (D-Gloucester)/Cardinale (R-Bergen) – Permits use of virtual or remote instruction to meet minimum 180-day school year requirement under certain circumstances. This is no longer a viable bill. See A A3904 above.

A3842/S2281, Greenwald (D-Camden)/Ruiz (D-Essex) – Establishes Bridging the Digital Divide in Schools Grant Program in DOE to provide and expand access to technology and equipment for students in certain school districts.

https://www.njleg.state.nj.us/2020/Bills/A4000/3842_I1.PDF

Passed both houses, on the Governor’s desk.

What does this mean for you? This would provide extra funding to provide and expand access to technology and equipment for students in certain school districts to access remote learning.

Update March 17, 2020

In response to member inquiries about the provision of services in the event of school closings due to Novel Coronavirus (COVID-19) this page will be updated with the most current information received.

New Jersey Department of Education (NJDOE) COVID-19: Frequently Asked Questions (FAQ) Related to School Emergency Preparedness Plans:
This document broadly addresses Special Education and Related Services and references the U.S. Department of Education Q & A document for more details:
COVID-19: Frequently Asked Questions (FAQ) Related to School Emergency Preparedness Plans, Updated March 13, 2020

 

US Department of Education Questions & Answers:
https://www2.ed.gov/policy/speced/guid/idea/memosdcltrs/qa-covid-19-03-12-2020.pdf

 

NJSHA’s lobbyist has reached out to the NJDOE with member question and concerns on delivery of speech-languages and audiological services should school districts close. In the interim, as a professional, be mindful the standard rules and regulations set forth in the special education code must be followed.

Please note that in August 2019, the New Jersey Department of Education (NJDOE) rescinded the guidance on telepractice in the schools, therefore telepractice may not be used as a service delivery model at this time.

NJ Early Intervention Professional

This US Dept of Education report states Part C services (Early intervention) can continue for toddlers that would be transitioning to PART B (school based) until an in-person evaluation can take place.  See page 11 of this report from US DOE. Re: IDEA. https://www2.ed.gov/documents/coronavirus/cares-waiver-report.pdf

Update March 23, 2020

New Jersey Early Intervention System Best Practice for Conducting Telehealth Visits During COVID-19 Operations

Update March 17, 2020

Department of Health Update on Early Intervention Services: Updated COVID-2019 and NJEIS Operations

Higher Education Issues/Clinical Supervision

The Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC) continues to monitor the COVID-19 pandemic and its impact on our profession.

Hearing the continued and long-term impact of the pandemic on your programs, plans and deadlines for the fall semester planning, and hearing how your programs quickly adapted to our new environment without sacrificing client/patient care and safety was greatly appreciated by the CFCC. During conference calls on May 15, 2020, the CFCC agreed to make additional accommodations to assist you and your students. There is also updated information regarding availability of Praxis examinations. Please share the information below with your students and colleagues.

  1. Speech-Language Pathology (SLP) accommodations for graduate student telepractice while being telesupervised: Clinical educators may telesupervise concurrent sessions delivered via telepractice as long as they supervise a minimum of 25% of the total contact time with each client/patient and are 100% accessible to the student. The number of concurrent sessions is up to the discretion of the clinical educator, their program director, and the program, and must comply with Council for Academic Accreditation (CAA) accreditation standards and with local, state, or federal laws regarding telepractice and telesupervision.
  2. Accommodations to the audiology and SLP certification standards have been extended through 12/31/2020 for programs that are unable to provide onsite in-person services due to COVID-19.
  3. In recognition of the essential healthcare services that audiologists and SLPs provide, the Audiology and SLP Praxis exams are now available at ETS testing centers that are permitted to be open by state and local officials. As of 5/15/2020, over two-thirds of ETS testing centers have reopened and more are reopening each week. For more information please visit www.ets.org/praxis. In addition, the Praxis at Home option also began on May 18, 2020 for the SLP Praxis.
Update April 29, 2020

The NJ Division of Consumer Affairs, Licensing Board has provided assurance that CFs may practice telehealth by statute in the Uniform Enforcement Act N.J.S.A. 45:1-62 et al.

Further, the Division is posting an alert on its website indicating clinical interns (i.e. CFs) who are two months away from the end of their supervision may submit the specified temp to perm application materials to Renee Clark via email. The Division has been licensing temp to perm individuals, as well as others. The specific information required to process temp to perm is being posted to the Division’s website.

The Division has advised NJSHA it is working on a solution to the on site direct supervision requirement. We will post any updates as we receive them.

Update April 22, 2020

ETS Professional Education Programs announces Praxis® at Home option due to the closure of testing centers. Read More from ETS.

Update April 15, 2020

Temporary Licensure Supervision Requirements for Clinical Fellows (CFs)

The present NJ licensure regulation N.J.A.C. 13:44C-3.5(f) states that “The supervisor shall provide a minimum of one hour of on-site direct supervision for each 20 hours of direct, face-to-face evaluation or therapeutic services rendered by the supervisee. Supervision shall take place not less than once a month” NJSHA is aware that this “onsite” supervision mandate does not currently allow for the CF to meet the supervision standard of “on-site” when performing telepractice services if the supervisor is not on-site. Given the current climate of COVID-19 and the extended mandatory “stay at home” order, this affects any Clinical Fellowships in process under a temporary license.

In response, NJSHA has submitted a letter to the licensing board on behalf of all NJ Clinical Fellows, asking for a temporary waiver of the “on-site direct” supervision requirement and requesting that “live direct supervision” be allowable during COVID-19. If approved, synchronous remote supervision of telepractice would allow for CF’s under a temporary license to continue to provide necessary services to be able to meet the requirements for permanent licensing.

The licensure board is aware of the issue that the on-site supervision requirement poses for clinical fellows and their respective supervisors. They are working to address this provision so that clinical fellows with temporary licenses can practice telemedicine without concern that they are not compliant with the regulation.

NJSHA is closely monitoring the situation and will provide any updates as they become available. Please also note, this applies only to CF’s practicing under a NJ temporary license.

Update April 9, 2020

Telesupervision and Telepractice guidelines for Graduate Student Interns
Graduate student clinicians enrolled in CAA-accredited and CAA-candidacy programs can engage in service delivery through telepractice when the clinical educator provides 100% direct supervision of the sessions in real time, either side-by-side with the student or with the student, the clinical educator, and the client/patient in different locations. This allowance is for both audiology and speech-language pathology programs.

Read the full statement here: https://www.asha.org/Certification/COVID-19-Use-of-Telepractice-and-Telesupervision/. Universities should contact their compliance officers and check the most recent federal guidance in order to determine which telepractice platforms would be considered HIPAA-compliant.

Please note the extension to August 1st of previous ASHA/CFCC guidance, which allows graduate student interns to collect clinical hours through distance learning (i.e., telepractice) in both university-based clinics and community clinical sites.

Update March 23, 2020

University students, faculty, and staff are grappling with a difficult reality, and have many questions about how clinical clock hours can be obtained in the context of COVID-19. With regard to telesupervision, we encourage members to follow ASHA and CAA guidance on this matter, as clinical supervision guidelines are not governed by individual states. With regard to telepractice however, in addition to ASHA and CAA guidelines, all state certification and licensure policies must also be adhered to.

We have gathered some of the pertinent information here, for your reference. ASHA’s Council for Clinical Certification (CFCC) released a special statement related to telepractice and telesupervision during the COVID-19 pandemic on March 13, 2020. They state:

“Graduate student clinicians enrolled in CAA-accredited and CAA-candidacy programs can engage in service delivery through telepractice when the clinical educator provides 100% direct supervision of the sessions in real time, either side-by-side with the student or with the student, the clinical educator, and the client/patient in different locations. This allowance is for both audiology and speech-language pathology programs.”

Read the full statement here: https://www.asha.org/Certification/COVID-19-Use-of-Telepractice-and-Telesupervision/. Universities should contact their compliance officers and check the most recent federal guidance in order to determine which telepractice platforms would be considered HIPAA-compliant.

Additionally, students may obtain up to 75 clock hours via simulation, and asynchronous supervision of simulations is permissible, as long as the supervisor follows best practice guidelines for de-briefing at least 15 minutes per hour of service (25% supervision). See the CFCC statement on supervision of simulations here: https://www.asha.org/certification/certification-standards-for-slp–clinical-simulation/#supervision

NJ Private Practice and Health Care Issues

NJSHA has compiled a list of various resources regarding loans, grants and other forms of financial assistance for small businesses:

The state’s DOL and Workforce Development created a webpage with resources such as FAQs, printable guides, and support for businesses related to benefits under the NJ Earned Sick Leave Law and COVID-19-related benefits for New Jersey employees.

US Chamber of Commerce Resources:

The US Chamber continues to create, update, and evolve its various guides and resources to continue bringing you and your members the information you need during this difficult time. We encourage you to utilize and share the following items as you see fit:

For more info, please visit the CDC’s Guidance for Businesses page.

Telepractice is allowed in New Jersey. NJSHA was involved in the passage of the Telemedicine/Telepractice bill which was signed in 2018. To read about it go to https://www.njsha.org/advocacy/triumphs/. The bill itself can be found at: Telemedicine/Tele-practice (2017) P.L. 2017, c 117. While the 2017 telepractice law does state that services rendered by teletherapy should be reimbursed the same as in person therapy, this is a New Jersey law and only applies to insurance plans written in NJ that are under Dept of Banking and Insurance (DOBI) oversight. Self-funded plans and federal health plans fall under federal oversight (ERISA). Thus, for those plans, NJSHA advises you to check with the insurance company regarding reimbursement for teletherapy.

If you plan to use teletherapy keep in mind the following:

  • SLPs who provide telepractice must comply with HIPAA, which means only HIPAA compliant platforms may be used. In order to be HIPAA compliant, the provider/organization must have a Business Associates Agreement (BAA) with the videoconferencing company. (Note there may be a change to this requirement, NJSHA is investigating this and will update this posting as appropriate).

Licensure laws require that the provider hold a license in both the state where the provider is located as well as the state where the client/patient is located.

ASHA has excellent guidelines which can be found at https://www.asha.org/Practice-Portal/Professional-Issues/Telepractice/
ASHA’s guidelines include the following:

  • Both you and the client/patient must have sufficient internet speed to engage in videoconferencing. Both need to have a camera and microphone.
  • For many patients/clients, someone else will need to be physically present with them during the session.
Below is information that has been provided from several insurance companies. Please keep in mind that since a teletherapy session is still a speech therapy session, each session counts towards annual limits and/or authorization limits. Also, even for plans that are waiving copays, if patient has a deductible, the deductible continues to apply and must be satisfied before copay waiver takes effect.

Fully funded plans MUST comply with P.L. 2017, c. 117 which mandates that if speech therapy is covered for face to face therapy then it must be covered the same as teletherapy.
NJ Department of Banking and Insurance, Telehealth Response, 3/30/20
Below is information that has been provided from several insurance companies. Please keep in mind that since a teletherapy session is still a speech therapy session:

    1. 1. Each session counts towards annual limits and/or authorization limits.
    1. 2. Even for plans that are waiving copays, if the patient has a deductible, the deductible continues to apply and must be satisfied before copay waiver takes effect.

The stated coverage of speech therapy provided by teletherapy assumes that in person speech therapy would be covered. As aforementioned, if the plan does not cover speech therapy provided in person, then it will not cover speech therapy provided by teletherapy.

The insurance companies are currently making many changes and working with limited staff. We have been advised that automated systems are in the process of being updated, and claims may be denied because the systems updates are not completed with so many changes that are occurring. Denials may need to be manually reviewed and reprocessed.

Fully funded plans MUST comply with P.L. 2017, c. 117 which mandates that if speech therapy is covered for face to face therapy then it must be covered the same as teletherapy.

In all cases NJSHA recommends you check the coverage, individual plan benefits, co-insurances and deductibles before initiating teleservices.

Update March 28, 2020
The following resources can be found on ASHA’s website:

Cigna has issued the following update:
https://static.cigna.com/assets/chcp/resourceLibrary/medicalResourcesList/medicalDoingBusinessWithCigna/medicalDbwcCOVID-19.html
The following virtual physical, occupational, and speech therapy (PT/OT/ST) services will be allowed through June 6, 2020 when appended with a GQ modifier and billed with a standard place of service code. These services will be reimbursed consistent with the standard fee schedule.
Speech Therapy

Code Description
92507 Speech/hearing therapy
92526 Oral function therapy

Important notes

      • Check the insurance plan to determine if additional CPT codes are covered.
      • Please note that while we encourage PT/OT/ST providers to follow CMS guidance regarding the use of software programs for virtual care, we are not requiring the use of any specific software program at this time.
      • We maintain all current medical necessity review criteria for virtual care at this time.

The following was in a bulletin sent from Aetna: “Aetna Commercial patients pay $0 for covered telemedicine visits until June 6, 2020. Until further notice, Aetna is also expanding coverage of telemedicine visits to its Aetna Medicare members, so they can receive the care they need from you without leaving their homes. With this change and new flexibilities announced by the Centers for Medicare and Medicaid Services to help combat the virus, Aetna Medicare members can now see their providers virtually via telephone or video.”
Aetna has stated that all plans, whether fully funded or self-funded, will cover teletherapy services with no pay until 6/6/20.

The following was posted on United Healthcare’s website:

Although the national public health emergency period currently has an end date of July 24, 2020, we know your work is far from over. The following resources will help you quickly reference the effective dates for UnitedHealthcare’s temporary benefit, program and procedure changes related to COVID-19, as well as billing guidelines for services such as COVID-19 testing, treatment and telehealth.

Program Date Summary
Our Summary of COVID-19 Dates by Program outlines the beginning and end dates of program, process or procedure changes that UnitedHealthcare implemented as a result of COVID-19. Full details of these changes, including applicable benefit plans and service information, can be found online. Please be aware of the following key dates:

  • June 1 – All currently effective prior authorization requirements and site of service reviews resume.
  • June 30 – Claims with a date of service on or after Jan. 1, 2020 will not be denied for timely filing if submitted by June 30, 2020.
  • July 24 – COVID-19 telehealth service coverage and related cost-share waivers for Individual and fully insured Group Market health plan members are extended through July 24, 2020. We’ll adhere to state regulations for Medicaid plans.
  • Sept. 30 – Cost share is waived for Medicare Advantage members for both primary and specialty office care visits, including telehealth, through Sept. 30, 2020.

Billing Guidance
To help you understand how UnitedHealthcare will reimburse services during the national public health emergency period, please download the COVID-19 Provider Billing Guidance. It outlines billing codes and modifiers. Because guidance may change, please check regularly for updates.

Update May 8, 2020

United Healthcare posted an update on covered services, including speech therapy and audiology: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/pa-covid19-updates.html?cid=em-providernews-covid-19nationalemail5-may20

Visit UHCprovider.com/covid19 for their complete COVID-19 resources

Update March 28, 2020

United Healthcare has posted the following update:
https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services/covid19-telehealth-pt-ot-st.html

According to ASHA, UHC applied the policy to their self-funded plans as their default position. Thus, unless an employer explicitly opts out, self-funded plans would also follow this policy.

Update March 26, 2020

COVID-19 Physical, Occupational and Speech Therapy Telehealth
United Healthcare will reimburse physical, occupational and speech therapy telehealth services provided by qualified health care professionals when rendered using interactive audio/video technology. State laws and regulations apply. Benefits will be processed in accordance with the member’s plan.

This change is effective immediately for dates of service March 18 through June 18, 2020.

Reimbursable codes are limited to the specific set of physical, occupational and speech therapy codes listed below. United Healthcare will reimburse eligible codes when submitted with a place of service code 02 and modifier 95.

Speech Therapy 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder
Speech Therapy 92521 Evaluation of speech fluency
Speech Therapy 92522 Evaluation of speech sound production
Speech Therapy 92523 Evaluation of speech sound production
Speech Therapy 92526 Treatment of swallowing dysfunction and/or oral function for feeding
Speech Therapy 96105 Assessment of Aphasia and Cognitive Performance Testing
Speech Therapy 97129 Cognitive therapy first 15 minute unit
Speech Therapy 97130 Cognitive therapy for each additional 15 minute unit (use in conjunction with 97129)

https://www.uhcprovider.com/content/dam/provider/docs/public/resources/news/2020/COVID19-Telehealth-Services-PT-OT-ST.pdf

Information received from Tricare representative and confirmed on Tricare website. There is no specific end date for teletherapy. Telehealth allowed until the declaration of the end of this national emergency. Per website:

These changes will remain for the duration of the stateside public health emergency.

No out-of-pocket costs for covered telehealth services

  • You won’t have out-of-pocket costs for telehealth services that TRICARE covers. TRICARE will now waive your cost-shares and copaymentA fixed dollar amount you may pay for a covered health care service or drug., and deductible (if applicable) for covered telehealth services you get from a military provider or TRICARE network provider. This waiver applies to all covered in-network telehealth services, not just the services related to COVID-19.
  • What if you do have to pay? TRICARE can’t immediately waive all copayments and cost-shares. You may have to pay up front and file a claim with your TRICARE contractor for reimbursement. If you have questions, contact your TRICARE contractor.

Referrals and authorizations are still applicable.

Update March 28, 2020

Tricare/Humana has posted the following update:
https://www.humanamilitary.com/provider/education-and-resources/quick-access/policy-updates-and-alerts/COVID-19-telemedicine-031320

Update March 18, 2020

Coronavirus Disease (COVID-19) and TRICARE’s telemedicine benefit
If a beneficiary meets all other criteria for a covered service for speech therapy and for continuation of PT/OT, (but not initiation of PT/OT), it is covered using telemedicine, using any coding modifiers as you would for a TRICARE network provider office visit.
Check the link for more details.

Horizon posted this information 4/2/20. It specifies the CPT codes covered for participating providers during COVID-19 and other information.
COVID-19 Update: Telemedicine Reimbursement Policy Addenda

All Horizon plans will cover speech therapy provided by teletherapy. Fully funded plans and NJX plans will waive copay. Self funded plans may or may not waive the copay.

Update March 27, 2020

Horizon recently posted an update to clarify which plans will cover teletherapy and which plans will waive the copay. The codes are currently being loaded and may take a few weeks to configure the systems in order for the claims to process correctly. However, you can still provide the service and submit your claim to Horizon and the claim will process correctly once the system is configured. The CPT codes that were added to the Horizon telehealth reimbursement policy are as a result of the COVID-19 crisis and the need to expand telemedicine services. The codes will remain eligible for telemedicine with the modifiers until further notice.

Here is a link to the most recent update:
https://www.horizonblue.com/providers/news/news-legal-notices/providing-telephonic-care-no-costs-members

Update March 23, 2020

Our lobbyist reached out to Horizon and gained confirmation that this insurer will be covering audiology and speech pathology services provided via telehealth and will be waiving co-pays. NJSHA provided Horizon with CPT codes under audiology and speech to ensure when the claims are submitted, they process correctly. We are awaiting confirmation that this coverage will be for all plans, including self-funded plans. In the meantime, we do have confirmation that the effective date will be the date of service driven, and the date when the system will be ready to accept these claims will be forthcoming in the next few days (info received 3/23/20). Horizon will be issuing a press release when the changes are ready and will also be providing a link to their updated policy. A letter was received by some providers 3/23/20 titled: COVID-19 UPDATE #4: Relaxing Rules to Enable Telephonic Visits
This states the new policy and verifies the information that teletherapy is covered, at the same rates and copays are waived.
“Speech Pathologists and Audiologists are eligible provider types to render telehealth services. Horizon does have a telehealth policy posted on our website.” It is:
https://www.horizonblue.com/providers/policies-procedures/policies/reimbursement-policies-guidelines/telemedicine-services
and this which waives copay during COVID 19
https://www.horizonhealthnews.com/horizon-eliminates-cost-sharing-for-qualified-in-network-telemedicine-services/

Horizon is in the process of adding the following CPT codes used by SLPs and audiologists to its system for teletherapy. We will notify our members once we receive this has been completed.

Codes Horizon will Cover by Teletherapy
Speech-language pathology codes: 92523, 92521, 92522, 92507, 92610, 92526, 92520, 92524
Audiology codes: 92592, 92593, 99211, 92625 Medicare

Per the American Speech and Hearing Association, State Advocates for Medicare Policy (StAMP) Network monthly network call on 5/5/2020:

Sarah Warren, Director, Health Care Policy, Medicare for American Speech-Language-Hearing Association (ASHA) discussed the Regulatory Components for Telecommunications, and Jerry White, Director of Federal Affairs in Health Care For ASHA discussed the Legislative Progression with Telepractice.

Sarah explained that ASHA, Occupational Therapy Association (AOTA), Physical Therapy Association (APTA) and other providers were on a call with CMS re: Telehealth prior to the StAMP Network Call.

As we already know, speech-langauge pathologists, physical therapists, and occupational therapists were considered suppliers and were unable to bill for telehealth which is no longer the case from a legislative perspective.

For Clarification:

  • Telepractice is defined as: the Clinic Practice (for our purposes speech therapy and audiology) and the Electronic Platform
  • Telehealth is defined as: Legal Payment Policy Concept. Congress WAIVED under the Social Security Act Section 18 that speech-language pathologists and audiologists are suppliers. MDs and practitioners initially were the only ones who were able to provide services under the Legal Payment Policy.

Speech-language pathologists and audiologists in specific settings may now do telehealth during this state of emergency only.

  • Telecommunications is the Legal work around/way around to complete Telecommunications: Audio/Visual, Face Time, Skype, Smart Phone, Telephone and E-Visits.

In term of regulations for physical, speech, audiology and occupational therapy:

  • Speech-language pathologists/audiologists in PRIVATE PRACTICE may bill for telehealth/telecommunication: audio and visually which includes face time/skyping, smart phone/telephone and e-vite. A modifier must be used, i.e., Modifier 95. There is a limitation of codes. ASHA has not been able to get CMS to approve coverage for ICD 10 Codes for Dysphagia or Cognitive Assessments for Therapy as of yet. ASHA is also seeking coverage for more audiology codes still at this time.
  • The Hospital Outpatient Departments (HOPD) are to bill for Telepractice and NOT Telehealth for Medicare outpatients. The outpatients must be REGISTERED as HOME EXTENSION SITES as a TEMPORARY SITE during the Pandemic/Healthcare State of Emergency. This is interpreted as “the patients will be billed as an IN Person Service even though will be treated remotely.” NO MODIFIER WILL BE USED AND THERE IS NO LIMITATION OF ICD 10 CODES for Medicare patients only.
  • Skilled Nursing Facilities (SNFs) MUST be ON SITE to Bill for Telepractice. Speech pathologists must be in the building (lobby or another room) of outside the window to conduct Telepractice. This is interpreted as “the patients will be billed as an IN Person Service even though will be treated remotely.” NO MODIFIER WILL BE USED AND THERE IS NO LIMITATION OF ICD 10 CODES for Medicare patients only. ASHA is actively working on this issue.
  • Home Health Therapy: is not covered to do any form of Telehealth or Telepractice at this time for Medicare patients. This is an IN PERSON STATUTE which REQUIRES a Legislative Change. ASHA is actively working on this issue.

 

Update May 1, 2020

Trump Administration Issues Second Round of Sweeping Changes to Support US Healthcare System During COVID-19 Pandemic

Further Expand Telehealth in Medicare:

CMS directed a historic expansion of telehealth services so that doctors and other providers can deliver a wider range of care to Medicare beneficiaries in their homes. Beneficiaries thus don’t have to travel to a healthcare facility and risk exposure to COVID-19.

  • For the duration of the COVID-19 emergency, CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others could deliver telehealth services. Now, other practitioners are able to provide telehealth services, including physical therapists, occupational therapists, and speech language pathologists.

ASHA clearly explains the CMS guidelines on SLPs and audiologists billing Medicare during this emergency. Note, this is not a permanent fix. The allowance is retroactive to March 1. View ASHA information.

Update April 2, 2020

The CMS advisement previously posted apparently was misleading. According to ASHA, the “fact sheet is not reflective of the text of the rule itself and is causing a great degree of confusion. First, the fact sheet refers to services, not clinicians. This is an important distinction:

  • Licensed clinical social worker services, clinical psychologist services, physical therapy services, occupational therapist services, and speech language pathology services can be paid for as Medicare telehealth services.

Second, the text of the rule states:

  • “However, we note that the statutory definition of distant site practitioners under section 1834(m) of the Act does not include physical therapists, occupational therapists, or speech-language pathologists, meaning that it does not provide for payment for these services as Medicare telehealth services when furnished by physical therapists, occupational therapists, or speech-language pathologists.”

Thus, at this time, NJSHA informs you that Medicare patients seen by teletherapy may not be billed to Medicare but rather must pay privately for their speech therapy services.

ASHA’s recent post on this may be found at:

https://www.asha.org/News/2020/ASHA-Continues-Seeking-Medicare-Telepractice-Authority/

We will continue to monitor this and inform you of any updates.

Update March 31, 2020

CMS issued the following bulletin today.
https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf?fbclid=IwAR1o6En7YQnvvjnXM5CpII7HzkKw3dUq55KQmiju4yMie2UJZsyCYQrrPUg

Among other changes, it specifically adds speech language evaluations and therapy to covered telehealth services under Medicare. The document states:

  • “Therapy Services, Physical and Occupational Therapy, All levels (CPT codes 97161- 97168; CPT codes 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521- 92524, 92507)
  • Radiation Treatment Management Services (CPT codes 77427)”
  • “Licensed clinical social worker services, clinical psychologist services, physical therapy services, occupational therapist services, and speech language pathology services can be paid for as Medicare telehealth services. A complete list of all Medicare telehealth services can be found here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

 

Update March 26, 2020

E visits for Medicare Part B:
In response to the spread of Corona Virus Disease 2019 (COVID-19), the Centers for Medicare & Medicaid Services (CMS) announced that “clinicians who may not independently bill for evaluation and management visits (for example, physical therapists, occupational therapists, speech-language pathologists, clinical psychologists)” can now bill for three Medicare G-codes for “e-visits,” effective immediately. The e-visit codes allow some qualified nonphysician health care professionals to report and receive payment for non-face-to-face digital communications that require a clinical decision. Prior to this announcement, audiologists, SLPs, and most other nonphysician groups could not bill Medicare for these services. It is important to note that the e-visits are not considered telepractice services. Here are the key things you need to know right now.

State Medicaid programs and commercial plans may allow audiologists and SLPs to report e-visits, but aren’t required to.

The following information outlines Medicare guidance and policy. State Medicaid agencies and commercial insurance plans have the flexibility to develop their own coverage policies related to e-visit services. Check with your payers directly to ask about coverage and payment for e-visits by audiologists or SLPs. You can direct them to this page for further information about use of these codes.

ASHA confirmed that audiologists may not bill for e-visits to the Medicare program. 

In its press release, CMS included SLPs as an example of clinicians who may now report e-visit services, but did not mention audiologists. ASHA reached out to CMS to determine whether audiologists may also report these services for Medicare beneficiaries and strongly urged that CMS provide equal access to these codes for audiologists. However, in subsequent communications with ASHA, CMS staff confirmed that audiologists may not report these services for Medicare beneficiaries, noting that e-visits are outside of the audiology diagnostic benefit category. Check with other non-Medicare payers to determine whether they will cover e-visits provided by audiologists.

The e-visit codes describe specific online communications that require a clinical decision and must meet specific criteria for appropriate billing.

The Medicare G-codes for e-visits are G2061-G2063 and include very specific parameters to determine whether an e-visit can be included on a Medicare Part B (outpatient) claim for payment.

  • G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
  • G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
  • G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

To correctly report G2061-G2063, the online assessment and management services must be:

  • initiated by an established/existing patient,
  • conducted through a patient portal,
  • medically necessary (requires clinical decision-making and is not for administrative or scheduling purposes), and
  • documented and stored to reflect the clinical decision-making and amount of cumulative time spent providing e-visit services to each patient.

Clinicians may report an e-visit code only once per seven consecutive days. Select the appropriate G-code based on the cumulative time spent providing e-visit services to each patient, through a patient portal, over the course of the seven days. Day one of the seven days begins on the first date you provide an e-visit. Telephone calls do not count towards the time for e-visits.

See ASHA’s website for clinical scenarios describing examples of services that could be reported using G2061-G2063.

CMS provides additional guidance on appropriate use of these codes in its March 17, 2020, press release.

Append the modifier GN to indicate services provided by an SLP. 

CMS staff confirmed that SLPs should include the GN modifier on claims for e-visits. To append the GN modifier, place it in the “modifier” section of the claim, on the same line as the G-code.

Use the place of service (POS) code that reflects the location of the billing provider.

When entering a POS code on a claim to describe where services occurred, clinicians should use the code that reflects where you provided the service, not where the patient received the service. For example, if a clinician provides the e-visit service from their private practice, enter POS 11 for “office”. Do not enter POS 12 for the patient’s home.

Check directly with your local Medicare Administrative Contractor (MAC) to clarify additional billing and claims processing guidelines.

ASHA provides the following information based on published guidance from CMS and discussions with CMS staff. Contact your local MAC for specific information and guidance related to implementation and payment for e-visit services.

The e-visit codes do not replace other services, such as evaluation and treatment of speech, language, swallowing, or hearing disorders. 

The e-visit codes do not represent real-time interactions and do not replace evaluation or treatment services described by existing Current Procedural Terminology (CPT ® American Medical Association) codes. These codes are limited in scope and reflect brief, patient-initiated check-ins or consultations that require clinical decision-making. Do not report these codes for services you would normally report using CPT codes, such as 92523 for a comprehensive speech and language evaluation. Additionally, CMS indicated the e-visits must be conducted via a patient portal, meaning that other forms of real-time or digital communication, such as e-mails outside of a portal, telephone calls, or text messages are not billable with these codes. CMS provided no additional guidance regarding the definition of a patient portal. Clinicians should check with their local MACs directly to verify whether there is flexibility to provide these services without a patient portal.

This is not an expansion of telepractice services.

CMS classifies G2061-G2063 as technology-based communication services, rather than as telepractice services. As a result, CMS has the authority to expand use of the e-visit codes to Medicare providers who are not authorized, by law, to provide telepractice services to Medicare beneficiaries. CMS has not extended telepractice services to audiologists and SLPs at this time. ASHA continues to advocate for expanded telepractice coverage across payers and will provide updates on the webpage on payment and coverage of telepractice services during COVID-19.

You may notify your patients regarding the availability of these services.

Although the patient must initiate the e-visits, clinicians can notify patients that these services are now available and authorized by Medicare. It is also important to note that the patient must verbally consent to the e-visit prior to initiation of services.

Medicare Part B (outpatient) pays for these services through the Medicare Physician Fee Schedule (MPFS).

The following table lists the national Medicare Part B payment rates for the e-visit G-codes. Actual rates will vary slightly depending on your locality. Although CMS waived cost-sharing requirements for telepractice services, the e-visits are still subject to Medicare’s 20% coinsurance payment from the patient because they are not part of the telepractice benefit. The MPFS does not deduct this amount, so the actual payment by Medicare is 20% less than outlined below. You must make reasonable efforts to collect the 20% coinsurance from the Medicare beneficiary.

2020 MPFS Payment Rates

G-Code Descriptor National Payment Rate ($)
G2061 Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes $12.27
G2062 11–20 minutes $21.65
G2063 21 or more minutes $33.92

Resources

Contact reimbursement@asha.org for additional information. Monitor ASHA’s website for the latest national and federal developments related to Medicare, Medicaid, and commercial insurance coverage of telepractice services during COVID-19.

Update March 23, 2020

CMS recently came out with an exception allowing Medicare participants to access healthcare through telemedicine.

https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

This guidance allows for G codes for e-consultations for speech language pathology but doesn’t speak to 92507. NJSHA reached out to CMS and ASHA for clarification. We received the following response from Sarah Warren, MA, Director, Health Care Policy, Medicare, ASHA.

“At this time the federal legal restrictions that prevent audiologists and SLPs from providing services via telehealth have not been waived. Therefore at this time services cannot be provided to Medicare beneficiaries via telehealth.

On Tuesday some waivers were made that would allow PTs, OTS, and SLPs to provide e-visits but this is not considered telehealth under federal law and e-visits do not replace or complement treatment such as swallowing or speech treatment.

On the ASHA website, ASHA has summarized the waiver that allows SLPs to provide e-visits and this includes some clinical vignettes to help our members understand the appropriate use of the e-visit codes.

https://www.asha.org/About/Coronavirus-Updates/

ASHA is engaging congress and Medicare to expand access to telehealth during this health crisis. All updates and these efforts will be posted to the same page referenced above that contains all of ASHA’s Covid-related updates. Please consider using our take action site to contact your members of congress to advocate for telehealth when provided by audiologists and SLPs.

https://takeaction.asha.org/asha/Telehealth

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

Update March 17, 2020

Information continues to change daily. If you are having concerns about COVID-19 and seeing patients in your private practice, NJSHA recommends that you contact your local board of health in the town your facility is located.
https://www.nj.gov/health/cd/topics/covid2019_schoolbusiness.shtml

Resources

New Jersey Division of Consumer Affairs

Telehealth Services During the COVID-19 Pandemic Frequently Asked Questions (FAQs)

State of NJ: Department of Human Services, Division of Developmental Disabilities

Please see the information from The NJ Department of Human Services COVID-19 Response related to practitioners providing services in Adult Day Programs and Residential Centers.
https://www.nj.gov/humanservices/ddd/documents/covid19-temporary-provider-funding.pdf

ASHA Links and Information 

FREE ASHA benefit for limited time to Learning Pass, several on Telepractice
https://learningcenter.asha.org/diweb/catalog/o/-d 

 

COVID-19 Updates

The SIG 18 Coordinating Committee compiled the following list of resources and hyperlinks to them for consideration before engaging in telehealth services.

      1. Consider the appropriateness of telehealth for meeting the needs of individuals.
      2. The organization must have a Business Associates Agreement (BAA) with the videoconferencing company.
      3. A Business Associates Agreement (BAA) is an agreement between your videoconferencing company and your employer that assures that the transmission of information from provider to client and client to provider is encrypted. Encryption is necessary to provide the first level of compliance with HIPAA & FERPA laws. (See ASHA’s Telepractice Practice Portal page for further information on HIPAA & FERPA). Encryption provides the SLP & employer a great assurance of providing client confidentiality.
      4. HOWEVER, A BAA IS NOT ENOUGH. To ensure that you are providing services that are compliant with HIPAA & FERPA you will need to implement the following:
      • a secure location for providing services that is not interrupted (e.g., having others walk into the room where you are providing service)
      • remote access to electronic documentation must be considered to protect client privacy and confidentiality at both sites.
      • Consult your state’s teacher certification and SLP/AuD licensure laws regarding use of telehealth.
      • Verify that you and the client have necessary equipment and internet speed to engage in a videoconference session.
      • Verify that someone will be physically present with the client/patient/student who can support your services.
      • Verify contact information for the client/patient/student including a phone number, email, physical address and relevant local emergency services.

ASHA members are encouraged to be informed and to advise stakeholders and other decision-makers on the implementation of telehealth.

Additional Resources Can Be Found At:

Information for Education Settings

FERPA:

(March 12, 2020), the U.S. Department of Education released guidance that pertains to serving students with disabilities during the COVID-19 pandemic. In addition, they provided information on FERPA and COVID-19 and the impact of COVID-19 on assessments and accountability under ESSA

The US Department of Education provides guidance letters for a variety of topics, including missed sessions. State and local education agencies can use those guidance letters to inform their advice to IEP teams charged with evaluating the impact of missed sessions on the provision of free appropriate public education (FAPE) for students.

Here are a list of links (including the ones above) that will be included on the ASHA Coronavirus/COVID-19 Updates page:

A new Telepractice Evidence Map has been added to ASHA’s Evidence Maps tool.

ASHA- Telepractice – General overview

NJ DOE Links

State of New Jersey Office of the Ombudsman for Individuals with Intellectual or Developmental Disabilities and Their Families: New Jersey COVID-19 Resources

US DOE Links
New Jersey Department of Education (NJDOE) COVID-19: Frequently Asked Questions (FAQ) Related to School Emergency Preparedness Plans:
COVID-19: Frequently Asked Questions (FAQ) Related to School Emergency Preparedness Plans, Updated March 13, 2020

US Department of Education Questions & Answers:
https://www2.ed.gov/policy/speced/guid/idea/memosdcltrs/qa-covid-19-03-12-2020.pdf

Related Information
Health and Safety:
Infection Control Resources for Audiologists and Speech-Language Pathologists

FREE Webinars:

General Telepractice Guidelines
State Telehealth Laws and Reimbursement Policies

COVID-19 Communication Tools for the Practitioner and the Public

Attention School-Based SLPs – Did you miss the Information Forum NJSHA held on April 1, 2020? Members can log into the Member Center to listen to the audio recording where Our lobbyist Lynn Nowak, NJSHA President Robynne Kratchman and NJSHA Legislative Chair Mary Faella addressed current issues regarding speech-language services in the schools related to changes due to COVID-19.

NJSHA also recommends regularly checking the CDC website for general guidance at Coronavirus Disease 2019-CDC is closely monitoring the novel coronavirus outbreak

Voices in Numbers!
We rally together for NJ SLPs, AUDs and those we serve.
With your support through membership, we can continue to have a powerful impact on the lives of many!

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The information contained on this webpage is accurate to the best of our knowledge as of the date of posting. The web page is informational only and may change without notice at any time. It should not be construed as legal advice. Please consult with an attorney for issues of legal significance.