Requires DOH to evaluate technology uses in long-term care settings, implements certain technological requirements within long-term care settings, and clarifies existing telehealth reimbursement parity includes long-term care settings.

A1160

ASSEMBLY, No. 1160

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblyman JOE DANIELSEN

District 17 (Middlesex and Somerset)

Assemblywoman SHANIQUE SPEIGHT

District 29 (Essex and Hudson)

Assemblywoman LUANNE M. PETERPAUL

District 11 (Monmouth)

SYNOPSIS

���� Requires DOH to evaluate technology uses in long-term
care settings, implements certain technological requirements within long-term
care settings, and clarifies existing telehealth reimbursement parity includes
long-term care settings.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act

concerning technology in long-term care
settings, and amending and supplementing various parts of statutory law.

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

���� 1.��� Section 6 of P.L.2020,
c.87 (C.26:2H-12.95) is amended to read as follows:

���� 6.��� a.� No later than 270
days after the effective date of
[
this
act
]

P.L.2020,
c.87 (C.26:2H-12.90 et seq.)
, each long-term care facility
, and no later
than 270 days after the effective date of
P.L. , c. (C. )
(pending before the Legislature as this act), each home and community based
services provider
shall implement or upgrade to an electronic health
record system certified by the Office of the National Coordinator for Health
Information Technology in the U.S. Department of Health and Human Services that
is capable of information sharing through industry standard data
interoperability, including application programming interface Health Level 7 or
fast healthcare interoperability technology.� Use cases built on this
technology shall include the bi-directional capability for admission discharge
and transfer and continuity of care through the clinical data architecture.�
Long-term care facilities
and
home and community
based services providers
interoperability for these use cases shall
be achieved by connecting to the New Jersey Health Information Network.

���� b.��� Subject to the
availability of funding for this purpose, the Department of Health shall make
grants available to long-term care facilities
and
home
and community based services providers:

����
(1)
��
to
provide assistance in implementing or upgrading to an electronic health record
system that meets the requirements of subsection a. of this section, which
grants shall be distributed to long-term care facilities
and
home and community based services providers

based on demonstrated need
; and

����
(2)�� to support the
exchange of user-friendly clinical information via an electronic health record
system that meets the requirements of subsection a. of this section with State
hospitals, which grants shall be distributed based on an evaluation of the
long-term care facility or
home and community based
services provider�s plan to utilize the grant award
to allow for timely
and well-informed clinical decisions across settings
.

(cf: P.L.2020, c.87, s.6)

����� 2.�� 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 December 31, 2024, a health benefits plan in this State shall provide
coverage and payment for health care services
, including those services
provided in a long-term care setting,
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.).

�����
�Long-term
care setting� means the variety of locations in which health care
services are provided to covered persons
with prolonged illnesses, disabilities, or cognitive disorders that support
independent and safe living according to the clinical needs of the person, and
includes home-based care, community-based care, and residential-based care.

(cf:
P.L.2023, c.199, s.1)

���� 3.��� (New section)� a.�
Commencing six months following the effective date of
P.L.���
, c.�� (C.�������� ) (pending before the Legislature as this act)
, the
Department of Health shall require each long-term care facility in the State,
as a condition of facility licensure, to provide internet, television, and
telephone services within each residential room of the facility.� To the extent
possible, and in compliance with the social isolation prevention policies
adopted by a long-term care facility pursuant section 2 of P.L.2020, c.113
(C.26:2H-12.98), the long-term care facility shall additionally provide
residents with the necessary equipment to utilize these services.

���� b.��� The department shall
distribute civil monetary penalty funds, as approved by the federal Centers for
Medicare and Medicaid Services, and any other available federal and State
funds, upon request, to facilities in order to comply with this section.

���� c.���� Whenever the department
conducts an inspection of a long-term care facility, the department's inspector
shall determine whether the long-term facility is in compliance with the
provisions of this section.

���� d.��� In addition to any other
applicable penalties provided by law, a long-term care facility that fails to
comply with the provisions of this section:�

���� (1)�� shall be liable to pay
an administrative penalty, the amount of which shall be determined in
accordance with a schedule established by department regulation, which schedule
shall provide for an enhanced administrative penalty in the case of a repeat or
ongoing violation; and

���� (2)�� may be subject to
adverse licensure action, as deemed by the department to be appropriate.

���� 4.��� (New section) a.� The
Department of Health, in collaboration with the Department of Human Services,
the Office of Long-Term Care Resiliency, the
Office of the State Long Term Care Ombudsman,
and
provider and community stakeholders, shall evaluate and review the use of
technology in long-term care settings within the State.� The goal of this
review shall be to identify existing uses of technology within long-term care
settings in the State, as well as potential uses of technology that have
demonstrated high success rates in improving service and quality of care in
long-term care settings, either in this State or other states, that have yet to
be broadly adopted in the State.� The review shall include recommendations for
the expansion and integration of technology within long-term care settings.� As
used in this section,
�long-term care setting�
means the variety of locations in which
services are provided to persons with prolonged illnesses,
disabilities, or cognitive disorders that support independent and safe living
according to the clinical needs of the person, and includes home-based care,
community-based care, and residential-based care.

���� b.��� The review at a minimum
shall include an assessment of, and recommendations for implementation
regarding:

���� (1)�� best practices in
long-term care settings for the use of artificial intelligence and smart
systems that improve administration and service delivery by reducing paperwork
documentation time, lowering the risk of falls, improving patient monitoring,
facilitating early intervention to address changes in the condition� of
chronically ill patients, maximizing patient independence, and providing for
any other applicable positive clinical or administrative outcome;

���� (2)�� the availability of
Wi-Fi services in long-term care facilities, and the extent to which residents
can access those services in private bedrooms, common areas, and corridors;

���� (3)�� the provision of
after-hours and weekend support through telemedicine and technology-based
solutions; and

���� (4)�� remote pharmacy
dispensing systems utilized at long-term care facilities.

���� c.���� Following the
completion of the review pursuant to subsection a. of this section, the
department shall encourage and support long-term care providers in implementing
the department�s recommendations regarding the uses of technology in long-term
care settings via the following:

���� (1)�� distributing civil
monetary penalty funds, as approved by the federal Centers for Medicare and
Medicaid Services, and any other available federal and State funds, upon
request;

���� (2)�� establishing grant or
low interest loan programs to distribute available federal or State funds via a
competitive process;

���� (3)�� implementing performance
incentives for long-term care providers that comply with the department�s
recommendations; or

���� (4)�� providing for any other
aid deemed appropriate and necessary by the Commissioner of Health.

���� d.���
No
later than 18 months after the effective date of this act, the department shall
submit a report to the Legislature, pursuant to section 2 of P.L.1991, c.164
(C.52:14-19.1), that summarizes the department�s findings and recommendations
pursuant subsection a. of this section and describes the department�s actions
pursuant to subsection c. of this section.

���� 5.��� This act shall take
effect immediately, and section 4 shall expire upon the submission of the
report pursuant to subsection d. of that section.

STATEMENT

���� This bill implements a variety
of provisions regarding technology in long-term care settings.� As used in the
bill, long-term care settings
include
home-based care, community-based care, and residential-based care.

���� First, the bill requires the Department
of Health (DOH), in collaboration with the applicable State entities and
provider stakeholders, to evaluate, review, and provide recommendations for the
use of technology in long-term care settings within the State, and to report
the findings of the review, and subsequent department actions, to the
Legislature within 18
months after the effective date
of the bill
.� The goal of this review is to identify existing uses, and
potential new and expanded uses, of technology within long-term care settings.�

���� Following the review, the
department will encourage and support providers in implementing the
department�s recommendations regarding the uses of technology via the
distribution of available federal and State funds, the establishment of grant
or low interest loan programs, the implementation of performance incentives, or
the provision of other aid deemed appropriate and necessary by the Commissioner
of Health.

���� Second, the bill expands an
existing law requiring long-term care facilities to implement an electronic
medical records requirement, and that provides need-based grants via the DOH to
implement this requirement, to also include home and community-based service
providers.� The bill also requires the DOH to provide grants to long-term care
providers
to support the exchange of user-friendly
clinical information via an electronic health record system with State
hospitals.�

���� Third, commencing six months
following the effective date of the bill, the DOH is to require each long-term
care facility in the State, as a condition of licensure, to provide internet,
television, and telephone services within each residential room.� To the extent
possible, the long-term care facility will also provide residents with the
necessary equipment to utilize these services.� The department will distribute
federal and State funds to facilities in compliance with this provision, and to
determine compliance with the provision during facility inspections.� In
addition to any other applicable penalties provided by law, a long-term care
facility that fails to comply with these provisions is liable to pay an
administrative penalty and may be subject to adverse licensure action.

���� Finally, this bill amends
section 11 of P.L.2021, c.310 to clarify that the provisions of that law
requiring a health benefits plan to provide coverage and payment parity for
health care services delivered to a covered person from December 31, 2023 to
December 31, 2024 through telemedicine or telehealth at a provider
reimbursement rate that equals the in-person provider reimbursement rate,
includes those health care services provided in a long-term care setting.���