New Jersey § 26:2s-29

§ 26:2s-29.

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 ).