A 4357 — Extends certain pay parity regarding telemedicine and telehealth.*

A4357 1R [First Reprint] ASSEMBLY, No.

Assemblywomen Brennan, McCoy, Assemblymen Kearney, Bhalla, Assemblywoman KatzKatz, Assemblymen Venezia, Sampson and AssemblymanAssemblywoman VeneziaPeterpaul         SYNOPSIS      Extends permanently certain pay parity regarding telemedicine and telehealth.

  CURRENT VERSION OF TEXT      As introduced.reported by the Assembly Health Committee on June 18, 2026, with amendments.

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

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

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

P.L.2021, c.310, s.1)s.1)]1        2.   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:

(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:

     “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.).al.).]1      11.  Section 11 of P.L.2021, c.310 is amended to read as follows:

       3.   11.  Thisa.  actFor 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 takeprovide effectcoverage immediately.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:

STATEMENT        This(1)   bill permanently extends section of P.L.2021, c.310, which is a provision that requires a carrier providing health benefits plans in the State to cover and pay for health care servicesservice deliveredprovided throughby a telemedicine or telehealth atorganization a provider reimbursement rate that equalsdoes thenot reimbursementprovide rate for identical services when delivered on an in-person basis in New Jersey, provided the services are covered by the health benefitscare planservice when delivered on an in-person basis in theNew State. 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.