Last week, Penn Medicine issued updated guidance about offering out of state telemedicine visits to patients who are located in New Jersey. We do not recommend cancelling already scheduled patient visits or interrupting care. However, you should stop scheduling additional New Jersey telemedicine visits until you have:

• Extended your temporary emergency reciprocity license (TERL) by applying for a permanent New Jersey license or you have received your permanent New Jersey license, AND
• You have obtained a leasing agreement with Clinical Healthcare Associates of New Jersey (CHCA).

The Connected Health team would like to provide additional information to support interpretation of this guidance for practitioners.

1. What actions do I need to take and when to…
   1. Obtain NJ licensure? New Jersey requires providers practicing their profession in New Jersey to be licensed by the applicable professional board. If you intend to provide patient care using telemedicine in New Jersey, you must obtain a New Jersey license. You can access your respective Board’s application by clicking here. If you have not already started this process, you must do so now. This can be a time-consuming process and can take several months.
   2. Obtain a leasing agreement with CHCA? If you have applied for an extension of your TERL or already have a permanent New Jersey license, you need to work with your Department or Division administrator to complete the CHCA leasing process. This process is applicable to physicians, advanced practice providers and other providers that bill for their services. Click here for more information. 
2. Can I offer telemedicine to patients located in New Jersey now…
   1. If I have an active New Jersey emergency license? Yes. Your TERL will allow you to provide telemedicine visits until it expires. If you are a Group 2 emergency license holder, you have until July 31st to apply for a permanent license if you would like your TERL to be extended until December 31st. If you have a TERL, you can start the CHCA leasing process now.
   2. If my emergency license has expired and I do not have a permanent New Jersey license or I do not have a leasing agreement with CHCA? In order to minimize the disruption to patient care, we will allow you to see already scheduled telehealth visits through December 31, 2021. After that date, you must either convert those visits to in-person visits or transfer that care to one of your New Jersey licensed colleagues. If you intend to continue practicing telemedicine with patients located in New Jersey after December 31st, you must have a permanent New Jersey license and obtain a CHCA leasing agreement.
   3. What about post-op visits? According to New Jersey law, scheduled post-op telehealth visits with patients located in New Jersey who had surgery in Pennsylvania should be handled by New Jersey licensed providers and in accordance with the above guidance.
3. How does this guidance impact staff such as registered nurses?
   1. According to New Jersey law, New Jersey licensure is required if directing care in a scheduled patient-facing interaction. Penn Medicine is performing an analysis to determine which clinical staff roles and activities will require New Jersey licensure and will follow up with an update soon.

Click here to download this memo as a PDF.

Dear Penn Medicine clinicians and staff,

Penn Medicine is committed to supporting the continued use of telehealth services where legally and clinically appropriate to increase access and meet our patients where they are, in line with our Penn Medicine Team Goals.

Telehealth-related waivers instated under the Public Health Emergency (PHE) have been extended beyond the end of the PHEs in both Pennsylvania and New Jersey and are still in effect through at least 09/30/21 in both states. HHS is anticipated to renew the Federal PHE on 07/20/21 through the end of the calendar year. The Connected Health team is working to develop a comprehensive post-Public Health Emergency policy, and details are forthcoming.  

All major payers continue to cover telehealth services at parity. Medicare MAPs payment for telehealth continues to be approximately $96 less per patient.

• Medicare is anticipated to extend expanded coverage through the end of the calendar year
• IBC rolled out permanent telemedicine coverage for Commercial members on 07/01/21
• Aetna’s expanded coverage is in effect until further notice
• PA Medicaid Plans coverage is in line with Pennsylvania telehealth waivers
• Horizon BCBS of NJ’s expanded coverage is in line with New Jersey telehealth waivers

As the policy and reimbursement landscape evolves, the Connected Health Team will continue to provide the latest information. We are available to address questions and concerns at PennConnectedHealth@pennmedicine.upenn.edu.

Click here to download this memo as a PDF.

Dear Penn Medicine BlueJeans user,

Thank you for your collaboration as we continually improve telehealth offerings and security throughout our health system. As we have previously communicated, to ensure optimal telehealth workflows and to meet best security and privacy standards, all BlueJeans meetings for clinical care/telehealth appointments will be required to be initiated through the Switchboard platform or, at LGH, through PennChart.

To ensure compliance with this, we will be deactivating and removing all individual Penn Medicine BlueJeans accounts on Wednesday, July 21, including yours.

This means that you will no longer be able to create/schedule meetings directly from the BlueJeans application. All BlueJeans meetings used for telehealth appointments will be generated and managed through the Switchboard platform or, at LGH, PennChart.

Individual Penn Medicine BlueJeans accounts are identified by a Penn Medicine logo on the BlueJeans account screen or meeting window. They are logged into through pennmedicine.bluejeans.com and have meeting URLs beginning with pennmedicine.bluejeans.com.

University of Pennsylvania BlueJeans accounts (identified by Penn logo on meeting screens and logged into with PennKey along with meeting URLs of upenn.bluejeans.com) will be unaffected by this change.

If you have been using your own individual Penn Medicine BlueJeans account for videoconferencing, you should consider taking steps to prepare for that account being deactivated please see this tip sheet for guidance. The tip sheet also describes the process for requesting an exception to maintain your individual account — exceptions will be granted in limited, appropriate circumstances.

Please continue to contact our help desk at 215-662-7474 or by placing a ticket via the IS service portal through the telemedicine support form if you have any questions or concerns. Our team members at Penn Medicine Connected Health look forward to supporting you and ensuring that your virtual visit needs are met through our telehealth platforms and that other needs you may have are met through approved platforms.

Thank you,

Penn Medicine Connected Health

Click here to download this memo as a PDF.

Why is Penn Medicine no longer authorizing out of state new patient visits for telehealth?

Scheduling of new patient out of state telehealth visits in a community setting (excluding those provided in a hospital setting e.g. inpatient or emergency room) has been disabled in PennChart due to clarifications in state laws and changes to state licensure waivers associated with the public health emergency. These changes include out of state licensure as well as out of state laws/regulations relating to employment, medical board supervision and billing.

What about out of state telehealth new patients that are already on my schedule?

Already scheduled telehealth NPVs may remain on provider schedules.

Who does this impact?

This change impacts any clinician who requires an out of state license and/or bills including physicians, APPs, nurses, genetic counselors, social workers, pharmacists, PT/OT and dieticians.

What if I am licensed in the state where the patient resides or is physically located at the time of the telehealth NPV?

Being licensed in the state where the patient resides or is located at the time of the telehealth visit is only one step in the process. Depending on the state where the visit is to occur (determined by the patient’s location at the time of the visit) there may be other state laws/regulations that require further review and steps we need to take to assure continuing compliance. It does not matter where the provider is physically located at the time of the visit. We are actively working with Information Services, Revenue Cycle and Schedgistration to create automated logic to address these required steps to enable us to resume out of state telehealth NPVs where legally permitted.

What about out of state established patients? What constitutes an established relationship?

This new guidance applies to NEW patient telehealth visits only. During the public health emergency, this guidance does not impact out of state established patients. An established patient is specific to the individual clinician NOT the practice.

What about our existing relationships and affiliations where we provide telemedicine services e.g. telestroke, teleICU or telegenetics to out-of-state hospital patients?

This new guidance does not impact existing telemedicine service and affiliation agreements that we have in place with out of state hospitals (i.e. Shore Medical, Bayhealth). Providers still need to be licensed in the state where the visit occurs and need to abide by the contractual relationships e.g. credentialing, etc.

What about reviewing the FSMB licensure grid prior to scheduling?

For the time being while we operationalize changes to our work flow, there is no need to research the FSMB. Scheduling of community based telehealth NPVs should stop while we work to create automated scheduling logic.

Click here to download this memo as a PDF.