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New Jersey Division of Consumer Expands Scope of Telemedicine to Include Management of Patients with Chronic Pain and Those Who Qualify for Medical Marijuana

New Jersey Division of Consumer Expands Scope of Telemedicine to Include Management of Patients with Chronic Pain and Those Who Qualify for Medical Marijuana

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Aug 31, 2020
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By Richard A. West, Esq.

New Jersey Division of Consumer Affairs Expands Access to Telemedicine Services, Including for Chronic Pain Patients and Patients Who Qualify for Medical Marijuana

The State of New Jersey continues to increase access to telehealth services during the COVID-19 pandemic. Earlier this month, the Division of Consumer Affairs announced expansion of telemedicine protocols, including for patients in treatment for chronic pain and those qualifying for medical marijuana therapy.

An Administrative Order, effective immediately, signed by the Acting Director of the Division, has temporarily waived various regulatory requirements for in-person medical evaluations when providers prescribe controlled dangerous substances (“CDS”) in the treatment of chronic pain or authorize medical marijuana. The action is the latest effort the Division has made in response to Governor Murphy’s March 20th directive to enable broad access to telehealth and telemedicine with the goal of reducing the spread of the COVID-19 virus.

From the Division news release: “New Jersey health care practices are again offering in-person services, but telehealth remains an important option for patients and providers,” said Attorney General Gurbir S. Grewal. “Today, we are making it easier for patients to choose telehealth services for any reason, including to avoid an in-person visit due to the continuing risk of COVID-19. Doctors who use telemedicine to prescribe CDS or authorize medical marijuana will be held to the same professional standards as for in-person visits and must comply with all of the important safeguards we have adopted to prevent diversion and misuse.”

The Executive Order allows health care professionals to utilize a telemedicine encounter to satisfy existing requirements for patient physical examinations before authorizing medical marijuana or prescribing, dispensing, or administering CDS. The Order is consistent with guidance from the federal Drug Enforcement Agency (“DEA”), which issued a temporary waiver permitting practitioners to prescribe a Schedule II CDS via telemedicine without an initial in-person examination, provided the prescription is issued for an approved medical purpose. Telemedicine communications are conducted using real-time, audio-visual, two-way interactive system and remain consistent with the required standard of care. Under New Jersey state law, health care professionals are required to discuss the risks and benefits of opioid medications and alternatives, to check the Prescription Monitoring Program, and to adhere to the five-day limit for the treatment of acute pain and the need to tailor subsequent prescribing to the patient’s current needs.

Quoting the Division’s press release: “This action temporarily removes barriers to providing patients with the medications they need to treat chronic pain and other diseases during the COVID-19 crisis,” said Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “This will ensure that those in need of vital prescriptions are able to get them, without unnecessarily putting themselves, fellow patients, and their healthcare providers at risk of exposure to COVID-19.”

The Order further allows health care professionals to use telemedicine encounters to conduct patient assessments and treatment plan reviews when continuously prescribing CDS for the management of chronic pain. Health care professionals remain obligated to document the results of patient assessments and treatment plan reviews in the patient record.

Finally, the Order also allows physicians to use telemedicine encounters to satisfy regulatory requirements for the issuance of a certification for the use of medical marijuana. Physicians may conduct a comprehensive medical history and an evaluation via telemedicine to make a diagnosis and manage the treatment of a qualifying condition. The telemedicine encounter must be conducted using an audio-visual, real-time, two-way interactive communication system, and remain consistent with normative care standards. A subsequent authorization for medical marijuana may also be provided via telemedicine if the physician determines that an in-person visit is not required, consistent with the standard of care.

The Order will remain in effect, unless expressly revoked or superseded by a subsequent Administrative Order issued by the Director of the Division of Consumer Affairs, until whichever of the following occurs first: (1) the end of the state of emergency or public health emergency declared by the Governor in Executive Order 103, whichever is later; or (2) the end of the telemedicine allowance designated by the United States Secretary of Health and Human Services on March 16, 2020, based upon the public health emergency declared by the Secretary on January 31, 2020.

The official Administrative Order can be viewed here:

https://www.nj.gov/oag/newsreleases20/AO-Telemedicine-Prescribing.pdf

BMK has been advising licensed professionals in recent months with to regard to myriad issues arising from the COVID-19 crisis. Should you have a question, please contact Brown Moskowitz & Kallen partner Richard A. West at (973) 376-0909 ext. 1126 or mobile: (973) 229-7928.

This article is for informational purposes only and is not intended to constitute, and does not constitute, legal advice.

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