Legislation requires all health benefits plans to provide expanded coverage for services provided using telemedicine and telehealth by increasing reimbursement for services.
OCEAN TOWNSHIP, NJ - Legislation introduced by Assemblywoman Joann Downey on Thursday would require all New Jersey health benefits plans, Medicaid and NJ FamilyCare, and the State Health Benefits Programs (SHBP) and School Employees’ Health Benefits Program (SEHBP) to provide expanded coverage for services provided using telemedicine and telehealth.
Specifically, the bill (A4179) would require all health insurance plans to reimburse medical providers for telehealth or telemedicine services with the same amount that they would receive for providing the same services in person.
The bill also prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from imposing “place of service” requirements on services provided using telemedicine and telehealth, and expressly allows licensed health care providers to provide services using telemedicine and telehealth.
The bill prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from placing restrictions on the electronic or technological platform used to provide telemedicine and telehealth, so long as the services provided when using that platform would meet the in-person standard of care for that service, and if the platform is otherwise compliant with the requirements of certain federal health privacy rules.
“If a doctor can provide the same quality of services virtually that they can in person, there’s no reason for insurance plans to discriminate by lowering that doctor’s reimbursement,” said Downey (D-Freehold). “We’ve seen throughout this pandemic that many services can be provided equally well through virtual means, often at lower cost or greater convenience to all parties involved. This can be especially meaningful for seniors or patients with disabilities, who can face real challenges when finding transportation to a doctor’s office. It’s time to move past an outdated model that punishes innovation and technology, and create a new paradigm that rewards efficiency and accessibility.”
Assemblyman Eric Houghtaling and Assemblywoman Joann Downey represent New Jersey’s 11th Legislative District in the State Assembly, where they work to make the Garden State more affordable for its hard-working residents. The 11th District includes the Monmouth County municipalities of Allenhurst, Asbury Park, Colts Neck, Deal, Eatontown, Freehold Borough, Freehold Township, Interlaken, Loch Arbour, Long Branch, Neptune City, Neptune, Ocean Township, Red Bank, Shrewsbury Borough, Shrewsbury Township, Tinton Falls and West Long Branch.