Bill would require insurers to cover telehealth like in-person doctor’s visits

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A bill requiring all New Jersey health benefits plans, Medicaid and NJ FamilyCare, and the State Health Benefits Programs and School Employees’ Health Benefits Program to cover telehealth services was introduced by Assemblywoman Joann Downey, D-11th District, last week and co-sponsored by Sen. Vin Gopal, D-11th District, on Tuesday.

Assembly Bill 4179 and Senate Bill 2559 would require all health insurance plans to reimburse providers for telehealth or telemedicine services with the same amount that they would be reimbursed for providing in-person services.

The bill prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from imposing “place of service” requirements on telemedicine and telehealth services, and allows the services to be provided virtually.

With the bill, health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP can’t place restrictions on the electronic or technological platform used to provide telemedicine and telehealth services as long as such services would meet the in-person standard of care, and as long as the platform is compliant with federal health privacy rules requirements.

“Telemedicine is medicine—and for many New Jerseyans, it’s one of the best options they’ve got,” said Gopal in a statement. “We can’t let bureaucratic red tape and old ways of thinking obstruct new ways of delivering health care services. This pandemic has been a case study in how effective—and, in many cases, how much more accessible—telehealth and telemedicine can be for New Jerseyans who need it. Let’s end the discrimination against virtual care and make sure that everyone can get coverage for the medical services they need.”

Telemedicine has surged since the onset of the COVID-19 pandemic, Hackensack Meridian Health Chief Executive Officer Robert Garrett told lawmakers last month.

UnitedHealthcare New Jersey CEO Paul Marden told NJBIZ in April he anticipated telehealth and remote-patient monitoring technologies playing a growing role in the promotion of well-being and disease detection and prevention.

“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 in a prepared statement.

“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,” she said. “It’s time to move past an outdated model that punishes innovation and technology, and create a new paradigm that rewards efficiency and accessibility.”