For more information about this blog post, please contact Khaled J. Klele, Ryan M. Magee, Labinot Alexander Berlajolli, or Connor Breza.

New Jersey’s Department of Health (“DOH”) adopted new rules, 53 N.J.R. 1378(b), effective August 16, 2021, outlining registration standards for telehealth and telemedicine organizations, including submission of an annual registration form to the DOH with a $1,500 fee. These rules were issued pursuant to N.J.S.A. 45:1-64. The rules apply only to organizations that are organized for the primary purpose of administering services in the furtherance of telehealth or telemedicine. In other words, organizations that provide telehealth or telemedicine services, as well as in‑person evaluation and care services, are not required to register or pay registration fees.

Under the rules, the DOH can suspend, revoke, or refuse to issue or renew an organization’s registration for failure to comply with the standards set forth in the rules, New Jersey’s telemedicine statute, N.J.S.A. 45:1‑61, et seq., and any other applicable rules or statutes, or if the DOH determines that the organization poses a threat to the public’s health, safety, or welfare. Non‑compliant telehealth and telemedicine organizations may also be subject to a monetary penalty of $1,000 per day beginning from the date of the first provided unauthorized service.

Telehealth and telemedicine organizations providing services in New Jersey as of August 16, 2021 must submit a registration application within 60 days from August 16, 2021, or cease providing telehealth or telemedicine services.

For more information about this blog post, please contact Khaled J. Klele, Ryan M. Magee, Labinot Alexander Berlajolli, or Connor Breza.

On August 20, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released guidance with respect to the timeline for implementation and enforcement of the new insurance price transparency rule. Citing the number of provisions that insurers are required to “implement by January 1, 2022 and the considerable time and effort required to make the machine-readable files available in the form and manner required in the TiC Final Rules at the same time,” the Departments of Labor, Health and Human Services, and the Treasury have decided to defer enforcement of the Transparency in Coverage (“TiC”) Final Rules requirement to publish the remaining machine-readable files until July 1, 2022.

The purpose of the TiC Final Rule is to increase transparency by requiring public disclosure of:

• in-network provider rates for covered items and services,
• out-of-network allowed amounts and billed charges for covered items and services, and
• negotiated rates and historical net prices for covered prescription drugs in three separate machine-readable files.

Notwithstanding the deferred enforcement, the machine-readable file requirements of the TiC Final Rules are applicable for plan years beginning on or after January 1, 2022.

However, CMS’s final price transparency rule applicable to hospitals took effect on January 1, 2021, and CMS has already sent approximately 165 warning letters to hospitals advising them of non-compliance. Per the language of the rule, in the event of noncompliance, CMS may:

• request that noncompliant hospitals undertake a corrective action plan,
• impose civil monetary penalties of up to $300 per day, or
• publicize the penalty on the CMS website.

The nonprofit group Patient Rights Advocate’s recent analysis between the period of May 15 and July 8, 2021 found that roughly 94.4% of hospitals are not in complete compliance with the final rule.  Hoping to incentivize compliance, CMS proposed a new rule on July 19, 2021 that could result in steeper penalties for non-compliant hospitals.