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New Jersey Legislature· S3947Approved by the Governor; P.L.2026, c.29

Extends certain pay parity regarding telemedicine and telehealth.*, the official text

Shown verbatim: the complete text as captured from the official page posted by the New Jersey Legislature, fetched 2026-08-28. Where this bill amends existing law, language marked for deletion in the official page appears here in brackets. This is the first reprint. The official bill page.
[First Reprint]

SENATE, No. 3947

STATE OF NEW JERSEY

222nd LEGISLATURE

INTRODUCED MARCH 16, 2026

Sponsored by:

Senator  VIN GOPAL

District 11 (Monmouth)

Senator  ROBERT W. SINGER

District 30 (Monmouth and Ocean)

Assemblywoman  MARGIE DONLON, M.D.

District 11 (Monmouth)

Assemblywoman  SHANIQUE SPEIGHT

District 29 (Essex and Hudson)

Assemblywoman  MARISA SWEENEY

District 25 (Morris and Passaic)

Co-Sponsored by:

Senators Diegnan, Greenstein, McKnight, Assemblywomen
Brennan, McCoy, Assemblymen Kearney, Bhalla, Assemblywoman Katz, Assemblymen
Venezia, Sampson, Assemblywomen Peterpaul and Bagolie

SYNOPSIS

Extends certain pay parity regarding telemedicine and
telehealth.

CURRENT VERSION OF TEXT

As reported by the Senate Health, Human Services and
Senior Citizens Committee on June 11, 2026, with amendments.

An Act regarding telemedicine and telehealth 1[,] and1 amending 1[P.L.2017,
c.117 and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.)] P.L.2021,
c.3101 .

Be It
Enacted by the Senate and General Assembly of
the State of New Jersey:

1[1. Section 8
of P.L.2017, c.117 (C.26:2S-29) is amended to read as follows:

8.    a.  A carrier that
offers a health benefits plan in this State shall provide coverage and payment
for health care services delivered to a covered person through telemedicine or
telehealth, on the same basis as[,
and at a provider reimbursement rate that does not exceed the provider
reimbursement rate that is applicable,]
when the services are delivered through in-person contact and consultation in
New Jersey, provided the services are otherwise covered under the plan when
delivered through in-person contact and consultation in New Jersey.
Reimbursement payments under this section may be provided either to the
individual practitioner who delivered the reimbursable services, or to the
agency, facility, or organization that employs the individual practitioner who
delivered the reimbursable services, as appropriate.

b.    A carrier may limit
coverage to services that are delivered by health care providers in the health
benefits plan's network, but may not charge any deductible, copayment, or
coinsurance for a health care service, delivered through telemedicine or
telehealth, in an amount that exceeds the deductible, copayment, or coinsurance
amount that is applicable to an in-person consultation.  In no case shall a
carrier:

(1)  impose any restrictions
on the location or setting of the distant site used by a health care provider
to provide services using telemedicine and telehealth or on the location or
setting of the originating site where the patient is located when receiving services
using telemedicine and telehealth, except to ensure that the services provided
using telemedicine and telehealth meet the same standard of care as would be
provided if the services were provided in person;

(2)  restrict the ability of a
provider to use any electronic or technological platform to provide services
using telemedicine or telehealth, including, but not limited to, interactive,
real-time, two-way audio, which may be used in combination with asynchronous
store-and-forward technology without video capabilities, including audio-only
telephone conversations, to provide services using telemedicine or telehealth,
provided that the platform used:

(a) allows the provider to
meet the same standard of care as would be provided if the services were
provided in person; and

(b)  is compliant with the
requirements of the federal health privacy rule set forth at 45 CFR Parts 160
and 164;

(3)  deny coverage for or
refuse to provide reimbursement for routine patient monitoring performed using
telemedicine and telehealth, including remote monitoring of a patient's vital
signs and routine check-ins with the patient to monitor the patient's status
and condition, if coverage and reimbursement would be provided if those
services are provided in person, and the provider is able to meet the same
standard of care as would be provided if the services were provided in person;
or

(4) limit coverage only to
services delivered by select third-party telemedicine or telehealth
organizations.

c.    Nothing in this section
shall be construed to:

(1)  prohibit a carrier from
providing coverage for only those services that are medically necessary,
subject to the terms and conditions of the covered person's health benefits
plan; or

(2)  allow a carrier to
require a covered person to use telemedicine or telehealth in lieu of receiving
an in-person service from an in-network provider.

d.    The Commissioner of
Banking and Insurance shall adopt rules and regulations, pursuant to the
"Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.),
to implement the provisions of this section.

e.    As used in this section:

"Asynchronous
store-and-forward" means the same as that term is defined by section 1 of
P.L.2017, c.117 (C.45:1-61).

"Carrier" means the
same as that term is defined by section 2 of P.L.1997, c.192 (C.26:2S-2).

"Covered person"
means the same as that term is defined by section 2 of P.L.1997, c.192
(C.26:2S-2).

"Distant site" means
the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).

"Health benefits
plan" means the same as that term is defined by section 2 of P.L.1997,
c.192 (C.26:2S-2).

"Originating site"
means the same as that term is defined by section 1 of P.L.2017, c.117
(C.45:1-61).

"Telehealth" means
the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).

"Telemedicine" means
the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).

"Telemedicine or
telehealth organization" means the same as that term is defined by section
1 of P.L.2017, c.117 (C.45:1-61).

(cf: P.L.2021, c.310, s.1)]

1[2. (New
section) A carrier that offers a health benefits plan in this State shall
provide coverage and payment for health care services delivered to a covered
person through telemedicine or telehealth at a provider reimbursement rate that
equals the provider reimbursement rate that is applicable, when the services
are delivered through in-person contact and consultation in New Jersey,
provided the services are otherwise covered by the health benefits plan when
delivered through in-person contact and consultation in New Jersey.  The
requirements of this subsection shall not apply to:

(1)  a health care service
provided by a telemedicine or telehealth organization that does not provide the
health care service on an in-person basis in New Jersey; or

(2) a physical health care
service that was provided through real-time, two-way audio without a video
component, whether or not utilized in combination with asynchronous
store-and-forward technology, including through audio-only telephone
conversation. The reimbursement rate for a physical health care service that is
subject to this paragraph shall be determined under the contract with the
provider; provided that the reimbursement rate for a physical health care
service when provided through audio-only telephone conversation shall be at
least 50 percent of the reimbursement rate for the service when provided in
person.

(3)  The provisions of
paragraph (2) of this subsection shall not apply to a behavioral health service
that was provided through real-time, two-way audio without a video component,
whether or not utilized in combination with asynchronous store-and-forward technology,
including audio-only telephone conversation.  A behavioral health care service
described in this paragraph shall be reimbursed at a rate that equals the
provider reimbursement rate for the service when provided in person.

b.    For the purposes of this
section:

“Carrier” means an insurance
company, health service corporation, hospital service corporation, medical
service corporation, or health maintenance organization authorized to issue
health benefits plans in this State.

“Covered person” means the
same as that term is defined in section 2 of P.L.1997, c.192 (C.26:2S-2); a
“benefits recipient” as that term is defined under section 7 of P.L.2017, c.117
(C.30:4D-6k); and a person covered under a contract purchased by the State
Health Benefits Commission or the School Employees’ Health Benefits Commission.

“Health benefits plan” means a
benefits plan which pays hospital or medical expense benefits for covered
services, and is delivered or issued for delivery in this State by or through a
carrier or a contract purchased by the State Health Benefits Commission or the
School Employees’ Health Benefits Commission.  The term shall include the State
Medicaid program established pursuant to P.L.1968, c.410 (C.30:4D-1 et seq.)
and the NJ FamilyCare program established pursuant to P.L.2005, c.156
(C.30:4J-8 et al.).]

11.  Section
11 of P.L.2021, c.310 is amended to read as follows:

11.
a. For the period beginning on the effective date of P.L.2021, c.310 and
ending on [July
1, 2026]
December 31, 2027, a health benefits plan in this State shall provide
coverage and payment for health care services delivered to a covered person
through telemedicine or telehealth at a provider reimbursement rate that equals
the provider reimbursement rate that is applicable, when the services are
delivered through in-person contact and consultation in New Jersey, provided
the services are otherwise covered by the health benefits plan when delivered
through in-person contact and consultation in New Jersey. The
requirements of this subsection shall not apply to:

(1) a health care service provided by a telemedicine or telehealth
organization that does not provide the health care service on an in-person
basis in New Jersey; or

(2) a
physical health care service that was provided through real-time, two-way audio
without a video component, whether or not utilized in combination with
asynchronous store-and-forward technology, including through audio-only telephone
conversation. The reimbursement rate for a physical health care service that is
subject to this paragraph shall be determined under the contract with the
provider; provided that the reimbursement rate for a physical health care
service when provided through audio-only telephone conversation shall be at
least 50 percent of the reimbursement rate for the service when provided in
person.

(3) The provisions of paragraph (2) of this subsection shall not
apply to a behavioral health service that was provided through real-time,
two-way audio without a video component, whether or not utilized in combination
with asynchronous store-and-forward technology, including audio-only telephone
conversation. A behavioral health care service described in this
paragraph shall be reimbursed at a rate that equals the provider reimbursement
rate for the service when provided in person.

b. For the purposes of this section:

“Carrier”
means an insurance company, health service corporation, hospital service
corporation, medical service corporation, or health maintenance organization
authorized to issue health benefits plans in this State.

“Covered
person” means the same as that term is defined in section 2 of P.L.1997, c.192
(C.26:2S-2); a “benefits recipient” as that term is defined under section 7 of
P.L.2017, c.117 (C.30:4D-6k); and a person covered under a contract purchased
by the State Health Benefits Commission or the School Employees’ Health
Benefits Commission.

“Health
benefits plan” means a benefits plan which pays hospital or medical expense
benefits for covered services, and is delivered or issued for delivery in this
State by or through a carrier or a contract purchased by the State Health
Benefits Commission or the School Employees’ Health Benefits Commission.
The term shall include the State Medicaid program established pursuant to
P.L.1968, c.410 (C.30:4D-1 et seq.) and the NJ FamilyCare program established
pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).1

(cf: P.L.2024, c.105, s.1)

1[3.] 2.1     This
act shall take effect immediately.
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