Measure Sponsored by Downey, Conaway, Houghtaling, Benson & Karabinchak
To improve access and affordability of care delivered remotely, Assembly Democrats Joann Downey, Herb Conaway, Eric Houghtaling, Daniel Benson and Robert Karabinchak sponsor legislation to provide expanded coverage for telemedicine and telehealth services. The measure was approved by the Assembly Health Committee on Tuesday.
Specifically, the bill (A-4179/4200) would require New Jersey health benefits plans, Medicaid and NJ FamilyCare, and the State Health Benefits Programs and School Employees’ Health Benefits Program to reimburse medical providers for telehealth and telemedicine services at the same rate as for equivalent in-person care in New Jersey.
“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-Monmouth). “We’ve seen throughout this pandemic that many services can be provided equally well through virtual means, often at lower cost and greater convenience to all parties involved.”
Current law provides that telemedicine and telehealth services may be reimbursed up to the amount at which in-person service is reimbursed.
“Our COVID-responsive expansions of telehealth and telemedicine were significant in spurring the implementation of remote care technologies,” said Conaway (D-Burlington). “Ensuring we can take advantage of this proliferation beyond the pandemic will be critical to providing better, well-rounded care.”
The bill would also prohibit health plans from limiting where care provided via telehealth and telemedicine could originate from, and from restricting the use of electronic or technological platforms if services meet the in-person standard of care and comply with certain federal health privacy rules.
“The challenge to successful delivery of virtual care has always been its expense,” said Houghtaling (D-Monmouth). “Equalizing reimbursement rates as this bill does allows more equitable costs to be passed on to patients making remote consultation a more cost-effective option.”
“This legislation paves the way for New Jersey to innovate and better address the broad spectrum of healthcare needs that exist,” said Benson (D-Mercer, Middlesex).
“Expanding access to different modes of care is critical to raise the quality of care provided in New Jersey,” said Karabinchak (D-Middlesex). “Particularly when it comes to underserved and aging communities, who may be especially challenged by the need to travel for an in-person doctor’s appointment.”
The bill now goes to the Speaker for further consideration.