Dive Brief:
- Two patients, an oncologist and a neurologist are suing the New Jersey State Board of Medical Examiners, alleging the state’s telehealth physician licensure requirements limit access to potentially lifesaving specialty care.
- The lawsuit, filed in New Jersey District Court last week, details two young patients who were able to receive telehealth consultations and follow-up care from out-of-state physicians after being diagnosed with rare brain tumors — options that are curtailed by the state’s rules that require physicians to be licensed in New Jersey when practicing remotely.
- The suit comes as loosened regulations on cross-state licensing adopted during the COVID-19 pandemic have begun to expire, which advocates argue can prevent patients from receiving care they need.
Dive Insight:
During the pandemic, New Jersey relaxed its requirements that providers must be licensed in the state to offer virtual care, allowing patients to see out-of-state physicians via telehealth if they had existing relationships. The state also “streamlined” the licensing process, waiving fees and allowing physicians to become licensed within 24 hours of applying, according to the suit.
But those flexibilities lapsed at the end of March. Now, the standard state licensing process can take significant documentation and months to process, the physicians in the suit allege.
The specialists argue they have expertise sought by patients across the nation, especially when local doctors don’t have the resources or experience to treat their conditions.
But obtaining and maintaining a number of state licenses with different requirements and deadlines is challenging for providers — and patients can’t easily travel for the number of consultations and follow-up appointments they may need.
“Without telemedicine, the cost and time commitment required to physically travel to each specialist’s office for consultation would preclude most patients from obtaining critical care,” the lawsuit states. “Moreover, without the opportunity for an initial consultation, a patient’s health may preclude her from traveling even if she had the financial resources.”
One plaintiff in the suit was diagnosed with pineoblastoma, a rare brain tumor, at 18 months old. After high-dose chemotherapy and two surgeries at their home hospital in New York didn’t work, the family spoke with a Massachusetts-based radiation oncologist using telehealth. The plaintiff traveled to Boston for care and has been able to receive virtual follow-up appointments to monitor his recovery.
A second plaintiff was diagnosed with craniocervical junction chordoma, a large tumor at the base of his skull, when he was 19 years old. He also was able to consult with out-of-state physicians remotely, relocated to receive care and later conducted follow-up appointments via telehealth.
Without access to out-of-state providers, patients might have to rely on local clinicians who might not have experience with rare diseases, the suit said. Patients like the two plaintiffs also need long-term monitoring to ensure their cancers don’t return — which could be challenging if they had to continually travel to review scans and discuss results with their doctors.
The lawsuit comes as lawmakers weigh making telehealth flexibilities introduced during the pandemic permanent. In a hearing last month, senators showed bipartisan support for accommodations in the Medicare program, like permitting visits outside of rural areas, or prescribing some controlled substances virtually, like those for treating opioid use disorder.
