With the outbreak of the COVID-19 virus and widespread stay-at-home orders, people with communication disorders in New Jersey who usually receive their critically needed speech therapy in a private practice or health care setting can now only continue their therapy through telemedicine/telehealth, via live video sessions with their speech-language pathologists.
It’s been state law since 2018 that any fully-funded medical insurance plan that covers traditional face-to-face speech therapy must also fund these special sessions, with the same payments, copays and session limits. Recently, the state Legislature passed two pieces of legislation that reiterate the coverage mandate for telemedicine during this crisis. Fortunately, the Governor quickly signed those bills into law. And at least one of the State’s insurers, Horizon, stepped up to the plate to ensure that speech therapy would be covered.
However, self-funded insurance plans – in which the employer assumes the financial risk of providing health care benefits to employees – are not subject to State law or regulation.
It is the hope of the New Jersey Speech-Language-Hearing Association that administrators of self-funded plans elect to do the right thing and cover teletherapy services.
What people, especially children, need now – more than ever – is consistency. To have progress made in speech therapy eroded because self-funded plans do not cover teletherapy is short-sighted. Suspending treatment will just become more expensive for all involved, including self-insured plans, and will lengthen the time of needed therapy thus costing more money to cover for lost time and care.
President New Jersey Speech-Language-Hearing Association