Authorizes health care professionals to engage in the use of remote patient monitoring devices; requires health care insurance coverage by certain insurers for remote patient monitoring devices.

A2201

ASSEMBLY, No. 2201

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman SHANIQUE SPEIGHT

District 29 (Essex and Hudson)

Assemblywoman ANNETTE QUIJANO

District 20 (Union)

SYNOPSIS

���� Authorizes health care professionals to engage in the
use of remote patient monitoring devices; requires health care insurance
coverage by certain insurers for remote patient monitoring devices.

CURRENT VERSION OF TEXT

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

��

An Act

concerning remote patient monitoring

devices and
amending
P.L.1968, c.413
and P.L.2017, c.117
.

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

����� 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,
or through the use of remote patient
monitoring devices,
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,
or through remote patient monitoring
devices,
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 remote patient monitoring devices,
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
or remote patient monitoring devices
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,
or remote
patient monitoring devices,
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,
or
remote patient monitoring devices,
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
or
remote patient monitoring devices
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).

����� "
Remote
patient monitoring devices" 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)

����� 2.�
Section 6 of P.L.1968, c.413 (C.30:4D-6) is amended to read as follows:

����� 6.�
a.� Subject to the requirements of Title XIX of the federal Social Security
Act, the limitations imposed by this act and by the rules and regulations
promulgated pursuant thereto, the department shall provide medical assistance
to qualified applicants, including authorized services within each of the
following classifications:

����� (1)�
Inpatient hospital services

����� (2)�
Outpatient hospital services;

����� (3)�
Other laboratory and X-ray services;

����� (4)�
(a). Skilled nursing or intermediate care facility services;

����� (b)�
Early and periodic screening and diagnosis of individuals who are eligible
under the program and are under age 21, to ascertain their physical or mental
health status and the health care, treatment, and other measures to correct or
ameliorate defects and chronic conditions discovered thereby, as may be
provided in regulation of the Secretary of the federal Department of Health and
Human Services and approved by the commissioner;

����� (5)
Physician's services furnished in the office, the patient's home, a hospital, a
skilled nursing, or intermediate care facility or elsewhere.

����� As
used in this subsection, "laboratory and X-ray services" includes HIV
drug resistance testing, including, but not limited to, genotype assays that
have been cleared or approved by the federal Food and Drug Administration,
laboratory developed genotype assays, phenotype assays, and other assays using
phenotype prediction with genotype comparison, for persons diagnosed with HIV
infection or AIDS.

����� b.�
Subject to the limitations imposed by federal law, by this act, and by the
rules and regulations promulgated pursuant thereto, the medical assistance
program may be expanded to include authorized services within each of the
following classifications:

����� (1)
Medical care not included in subsection a.(5) above, or any other type of
remedial care recognized under State law, furnished by licensed practitioners
within the scope of their practice, as defined by State law;

����� (2)
Home health care services;

����� (3)
Clinic services;

����� (4)
Dental services;

����� (5)
Physical therapy and related services;

����� (6)
Prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed
by a physician skilled in diseases of the eye or by an optometrist, whichever
the individual may select;

����� (7)
Optometric services;

����� (8)
Podiatric services;

����� (9)
Chiropractic services;

����� (10)
Psychological services;

����� (11)
Inpatient psychiatric hospital services for individuals under 21 years of age,
or under age 22 if they are receiving such services immediately before
attaining age 21;

����� (12)
Other diagnostic, screening, preventative, and rehabilitative services, and
other remedial care;

����� (13)
Inpatient hospital services, nursing facility services, and immediate care
facility services for individuals 65 years of age or over in an institution for
mental diseases;

����� (14)
Intermediate care facility services;

����� (15)
Transportation services;

����� (16)
Services in connection with the inpatient or outpatient treatment or care of
substance use disorder, when the treatment is prescribed by a physician and
provided in a licensed hospital or in a narcotic and substance use disorder
treatment center approved by the Department of Health pursuant to P.L.1970,
c.334 (C.26:2G-21 et. seq.) and whose staff includes a medical director, and
limited those services eligible for federal financial participation under Title
XIX of the federal Social Security Act;

����� (17)
Any other medical care and any other type of remedial care recognized under
State law, specified by the Secretary of the federal Department of Health and
Human Services, and approved by the commissioner;

����� (18)
Comprehensive maternity care, which may include: the basic number of prenatal
and postpartum visits recommended by the American College of Obstetrics and
Gynecology; additional prenatal and postpartum visits that are medically
necessary; necessary laboratory, nutritional assessment and counseling, health
education, personal counseling, managed care, outreach, and follow-up services;
treatment of conditions which may complicate pregnancy doula care; and
physician or certified nurse midwife delivery services.� For the purposes of
this paragraph, "doula" means a trained professional who provides
continuous physical, emotional, and informational support to a mother before,
during, and shortly after childbirth, to help her to achieve the healthiest,
most satisfying experience possible;

����� (19)
Comprehensive pediatric care, which may include: ambulatory, preventive, and
primary care health services.� The preventive services shall include, at a
minimum, the basic number of preventive visits recommended by the American
Academy of Pediatrics;

����� (20)
Services provided by a hospice which is participating in the Medicare program
established pursuant to Title XVIII of the Social Security Act, Pub.L.89-97 (42
U.S.C. s.1395 et seq.).� Hospice services shall be provided subject to approval
of the Secretary of the federal Department of Health and Human Services for
federal reimbursement;

����� (21)
Mammograms, subject to approval of the Secretary of the federal Department of
Health and Human Services for federal reimbursement, including one baseline
mammogram for women who are at least 35 but less than 40 years of age; one
mammogram examination every two years or more frequently, if recommended by a
physician, for women who are at least 40 but less than 50 years of age; and one
mammogram examination every year for women age 50 and over;

����� (22)
Upon referral by a physician, advanced practice nurse, or physician assistant
of a person who has been diagnosed with diabetes, gestational diabetes, or
pre-diabetes, in accordance with standards adopted by the American Diabetes
Association:

����� (a)
Expenses for diabetes self-management education or training to ensure that a
person with diabetes, gestational diabetes, or pre-diabetes can optimize
metabolic control, prevent and manage complications, and maximize quality of
life.� Diabetes self-management education shall be provided by an in-State
provider who is:

����� (i)
a licensed, registered, or certified health care professional who is certified
by the National Certification Board of Diabetes Educators as a Certified
Diabetes Educator, or certified by the American Association of Diabetes
Educators with a Board Certified-Advanced Diabetes Management credential,
including, but not limited to: a physician, an advanced practice or registered
nurse, a physician assistant, a pharmacist, a chiropractor, a dietitian
registered by a nationally recognized professional association of dietitians,
or a nutritionist holding a certified nutritionist specialist (CNS) credential
from the Board for Certification of Nutrition Specialists; or

����� (ii)
an entity meeting the National Standards for Diabetes Self-Management Education
and Support, as evidenced by a recognition by the American Diabetes Association
or accreditation by the American Association of Diabetes Educators;

����� (b)
Expenses for medical nutrition therapy as an effective component of the
person's overall treatment plan upon a: diagnosis of diabetes, gestational
diabetes, or pre-diabetes; change in the beneficiary's medical condition,
treatment, or diagnosis; or determination of a physician, advanced practice
nurse, or physician assistant that reeducation or refresher education is
necessary.� Medical nutrition therapy shall be provided by an in-State provider
who is a dietitian registered by a nationally-recognized professional
association of dietitians, or a nutritionist holding a certified nutritionist
specialist (CNS) credential from the Board for Certification of Nutrition
Specialists, who is familiar with the components of diabetes medical nutrition
therapy;

����� (c)
For a person diagnosed with pre-diabetes, items and services furnished under an
in-State diabetes prevention program that meets the standards of the National
Diabetes Prevention Program, as established by the federal Centers for Disease
Control and Prevention; and

����� (d)
Expenses for any medically appropriate and necessary supplies and equipment
recommended or prescribed by a physician, advanced practice nurse, or physician
assistant for the management and treatment of diabetes, gestational diabetes,
or pre-diabetes, including, but not limited to: equipment and supplies for
self-management of blood glucose; insulin pens; insulin pumps and related
supplies; and other insulin delivery devices;

����� (23)
Expenses incurred for the provision of group prenatal services to a pregnant
woman, provided that:

����� (a)
the provider of such services, which shall include, but not be limited to, a
federally qualified health center or a community health center operating in the
State:

����� (i)
is a site accredited by the Centering Healthcare Institute, or is a site
engaged in an active implementation contract with the Centering Healthcare
institute, that utilizes the Centering Pregnancy model; and

����� (ii)
incorporates the applicable information outlined in any best practices manual
for prenatal and postpartum maternal care developed by the Department of Health
into the curriculum for each group prenatal visit;

����� (b)
each group prenatal care visit is at least 1.5 hours in duration, with a.
minimum of two women and a maximum of 20 women in participation; and

����� (c)
no more than 10 group prenatal care visits occur per pregnancy.� As used in
this paragraph, "group prenatal care services" means a series of
prenatal care visits provided in a group setting which are based upon the
Centering Pregnancy model developed by the Centering Healthcare Institute and
which include health assessments, social and clinical support, and educational
activities;

����� (24)
Expenses incurred for the provision of pasteurized donated human breast milk,
which shall include human milk fortifiers if indicated in a medical order
provided by a licensed medical practitioner, to an infant under the age of six
months; provided that the milk is obtained from a human milk bank that meets
quality guidelines established by the Department of Health and a licensed
medical practitioner has issued a medical order for the infant under at least
one of the following circumstances:

����� (a)
the infant is medically or physically unable to receive maternal breast milk or
participate in breast feeding, or the infant's mother is medically or
physically unable to produce maternal breast milk in sufficient quantities or
participate in breast feeding despite optimal lactation support; or

����� (b)
the infant meets any of the following conditions:

����� (i)
a body weight below healthy levels, as determined by the licensed medical
practitioner issuing the medical order for the infant;

����� (ii)
the infant has a congenital or acquired condition that places the infant at a
high risk for development of necrotizing enterocolitis; or

����� (iii)
the infant has a congenital or acquired condition that may benefit from the use
of donor breast milk and human milk fortifiers, as determined by the Department
of Health;

����� (25)
Comprehensive tobacco cessation benefits to an individual who is 18 years of
age or older, or who is pregnant.� Coverage shall include: brief and high
intensity individual counseling, brief and high intensity group counseling, and
telemedicine as defined by section 1 of P.L.2017, c.117 (C.45:1-61); all
medications approved for tobacco cessation by the U.S. Food and Drug
Administration; and other tobacco cessation counseling recommended by the
Treating Tobacco Use and Dependence Clinical Practice Guideline issued by the
U.S. Public Health Service.� Notwithstanding the provisions of any other law,
rule, or regulation to the contrary, and except as otherwise provided in this
section:

����� (a)
Information regarding the availability of the tobacco cessation services
described in this paragraph shall be provided to all individuals authorized to
receive the tobacco cessation services pursuant to this paragraph at the
following times: no later than 90 days after the effective date of P.L.2019,
c.473: upon the establishment of an individual's eligibility for medical
assistance; and upon the redetermination of an individual's eligibility for
medical assistance;

����� (b)
The following conditions shall not be imposed on any tobacco cessation services
provided pursuant to this paragraph: copayments or any other forms of
cost-sharing, including deductibles; counseling requirements for medication;
stepped care therapy or similar restrictions requiring the use of one service
prior to another; limits on the duration of services; or annual or lifetime
limits on the amount, frequency, or cost of services, including, but not
limited to, annual or lifetime limits on the number of covered attempts to
quit; and

����� (c)
Prior authorization requirements shall not be imposed on any tobacco cessation
services provided pursuant to this paragraph except in the following
circumstances where prior authorization may be required: for a treatment that
exceeds the duration recommended by the most recently published United States
Public Health Service clinical practice guidelines on treating tobacco use and
dependence; or for services associated with more than two attempts to quit
within a 12-month period;
[
and
]

����� (26)
Provided that there is federal financial participation available, benefits for
expenses incurred in conducting a colorectal cancer screening in accordance
with United States Preventive Services Task Force recommendations.� The method
and frequency of screening to be utilized shall be in accordance with the most
recent published recommendations of the United States Preventive Services Task
Force and as determined medically necessary by the covered person's physician,
in consultation with the covered person.

����� No
deductible, coinsurance, copayment, or any other cost-sharing requirement shall
be imposed for a colonoscopy performed following a positive result on a
non-colonoscopy, colorectal cancer screening test recommended by the United
States Preventive Services Task Force
; and

�����
(27)
Expenses incurred for the

remote patient
monitoring device, as defined in section 1 of P.L.2017, c.117 (CC.45:1-61), of
a patient who is pregnant
.

����� c.�
Payments for the foregoing services, goods and supplies furnished pursuant to
this act shall be made to the extent authorized by this act, the rules and
regulations promulgated pursuant thereto and, where applicable, subject to the
agreement of insurance provided for under this act.� The payments shall
constitute payment in full to the provider on behalf of the recipient.� Every
provider making a claim for payment pursuant to this act shall certify in
writing on the claim submitted that no additional amount will be charged to the
recipient, the recipient's family, the recipient's representative or others on
the recipient's behalf for the services, goods, and supplies furnished pursuant
to this act.

����� No
provider whose claim for payment pursuant to this act has been denied because
the services, goods, or supplies were determined to be medically unnecessary
shall seek reimbursement form the recipient, his family, his representative or
others on his behalf for such services, goods, and supplies provided pursuant
to this act; provided, however, a provided may seek reimbursement from a
recipient for services, goods, or supplies not authorized by this act, if the
recipient elected to receive the services, goods or supplies with the knowledge
that they were not authorized.

����� d.�
Any individual eligible for medical assistance (including drugs) may obtain
such assistance from any person qualified to 33 perform the service or services
required (including an organization which provides such services, or arranges
for their availability on a prepayment basis), who undertakes to provide the
individual such services.

����� No
copayment or other form of cost-sharing shall be imposed on any individual
eligible for medical assistance, except as mandated by federal law as a
condition of federal financial participation.

����� e.�
Anything in this act to the contrary notwithstanding, no payments for medical
assistance shall be made under this act with respect to care or services for
any individual who:

����� (1)
Is an inmate of a public institution (except as a patient in a medical
institution); provided, however, that an individual who is otherwise eligible
may continue to receive services for the month in which he becomes an inmate,
should the commissioner determine to expand the scope of Medicaid eligibility
to include such an individual, subject to the limitations imposed by federal
law and regulations, or

����� (2)
Has not attained 65 years of age and who is a patient in an institution for
mental diseases, or

����� (3)
Is over 21 years of age and who is receiving inpatient psychiatric hospital
services in a psychiatric facility; provided, however, that an individual who
was receiving such services immediately prior to attaining age 21 may continue
to receive such services until the individual reaches age 22.� Nothing in this
subsection shall prohibit the commissioner from extending medical assistance to
all eligible persons receiving inpatient psychiatric services; provided that
there is federal financial participation available.

����� f.�
(1) A third party as defined in section 3 of P.L.1968, c.413 (C.30:4D-3) shall
not consider a person's eligibility for Medicaid in this or another state when
determining the person's eligibility for enrollment or the provision of
benefits by that third party.

����� (2)
In addition, any provision in a contract of insurance, health benefits plan, or
other health care coverage document, will, trust, agreement, court order, or
other instrument which reduces or excludes coverage or payment for health
care-related goods and services to or for an individual because of that
individual's actual or potential eligibility for or receipt of Medicaid
benefits shall be null and void, and no payments shall be made under this act
as a result of any such provision.

����� (3)
Notwithstanding any provision of law to the contrary, the provisions of
paragraph (2) of this subsection shall not apply to a trust agreement that is
established pursuant to 42 U.S.C. s.1396p(d)(4)(A) or (C) to supplement and
augment assistance provided by government entities to a person who is disabled
as defined in section 1614(a)(3) of the federal Social Security Act (42 31
U.S.C. s.1382c (a)(3)).

����� g.�
The following services shall be provided to eligible medically needy
individuals as follows:

����� (1)
Pregnant women shall be provided prenatal care and delivery services and
postpartum care, including the services cited in subsections a.(1), (3), and
(5) of this section and subsections b.(1)-(10), (12), (15), and (17) of this
section, and nursing facility services cited in subsection b.(13) of this
section.

����� (2)
Dependent children shall be provided with services cited in subsections a.(3)
and (5) of this section and subsections b.(1), (2), (3), (4), (5), (6), (7),
(10), (12), (15), and (17) of this section, and nursing facility services cited
in subsection b.(13) of this section.

����� (3)
Individuals who are 65 years of age or older shall be provided with services
cited in subsections a.(3) and (5) of this section and subsections b.(1)-(5),
(6) excluding prescribed drugs, (7), (8), (10), (12), (15), and (17) of this
section, and nursing facility services cited in subsection b.(13) of this
section.

����� (4)
Individuals who are blind or disabled shall be provided with services cited in
subsections a.(3) and (5) of this section and subsections b.(1)-(5), (6)
excluding prescribed drugs, (7), (8), (10), 3 (12), (15), and (17) of this
section, and nursing facility services cited in subsection b.(13) of this
section.

����� (5)
(a) Inpatient hospital services, subsection a.(1) of this section, shall only
be provided to eligible medically needy individuals, other than pregnant women,
if the federal Department of Health and Human Services discontinues the State's
waiver to establish inpatient hospital reimbursement rates for the Medicare and
Medicaid programs under the authority of section 601(c)(3) of the Social
Security Act Amendments of 1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)).�
Inpatient hospital services may be extended to other eligible medically needy
individuals if the federal Department of Health and Human Services directs that
these services be included.

����� (b)
Outpatient hospital services, subsection a.(2) of this section, shall only be
provided to eligible medically needy individuals if the federal Department of
Health and Human Services discontinues the State's waiver to establish
outpatient hospital reimbursement rates for the Medicare and Medicaid programs
under the authority of section 601(c)(3) of the Social Security Amendments of
1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)).� Outpatient hospital services may
be extended to all or to certain medically needy individuals if the federal
Department of Health and Human Services directs that these services be
included.� However, the use of outpatient hospital services shall be limited to
clinic services and to emergency room services for injuries and significant
acute medical conditions.

����� (c)
The division shall monitor the use of inpatient and outpatient hospital
services by medically needy persons.

����� h.�
In the case of a qualified disabled and working individual pursuant to section
h6408 of Pub.L.101-239 (42 U.S.C. s.1396d), the only medical assistance
provided under this act shall be the payment of premiums for Medicare part A
under 42 U.S.C. ss.1395i-2 and 1395r.

����� i.�
In the case of a specified low-income Medicare beneficiary pursuant to 42
U.S.C. s.1396a(a)10(E)iii, the only medical assistance provided under this act
shall be the payment of premiums for Medicare part B under 42 U.S.C. s.1395r as
provided for in 42 U.S.C. s.1396d(p)(3)(A)(ii).

����� j.�
In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(aa), the
only medical assistance provided under this act shall be payment for authorized
services provided during the period in which the individual requires treatment
for breast or cervical cancer, in accordance with criteria established by the
commissioner.

����� k.�
In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(ii), the
only medical assistance provided under this act shall be payment for family
planning services and supplies as described at 42 U.S.C. s.1396d(a)(4)(C),
including medical diagnosis and treatment services that are provided pursuant
to a family planning service in a family planning setting.

(cf:
P.L.2023, c.187, s.1)

�������
3.� Section 7 of P.L.2017, c.117 (C.30:4D-6k) is
amended to read as follows:

����� 7.�
a.� The State Medicaid and NJ FamilyCare programs shall provide coverage and
payment for health care services delivered to a benefits recipient through
telemedicine or telehealth,
or through the use of remote patient monitoring
devices,
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 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.�
The State Medicaid and NJ FamilyCare programs may limit coverage to services
that are delivered by participating health care providers, but may not charge
any deductible, copayment, or coinsurance for a health care service, delivered
through telemedicine or telehealth,
or through the use of remote patient
monitoring devices,
in an amount that exceeds the deductible, copayment, or
coinsurance amount that is applicable to an in-person consultation.� In no case
shall the State Medicaid and NJ FamilyCare programs:

����� (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 remote patient monitoring devices,
or on the location or setting of the
originating site where the patient is located when receiving services using
telemedicine and telehealth,
or remote patient monitoring devices,

except to ensure that the services provided using telemedicine and telehealth
or
remote patient monitoring devices
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,
or remote
patient monitoring devices,
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,
or
remote patient monitoring devices,
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 the State Medicaid or NJ FamilyCare programs from providing coverage
for only those services that are medically necessary, subject to the terms and
conditions of the recipient's benefits plan; or

����� (2)
allow the State Medicaid or NJ FamilyCare programs to require a benefits
recipient to use telemedicine or telehealth
or remote patient monitoring
devices
in lieu of obtaining an in-person service from a participating
health care provider.

����� d.�
The Commissioner of Human Services, in consultation with the Commissioner of
Children and Families, shall apply for such State plan amendments or waivers as
may be necessary to implement the provisions of this section and to secure
federal financial participation for State expenditures under the federal
Medicaid program and Children's Health Insurance Program.

����� 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).

����� "Benefits
recipient" or "recipient" means a person who is eligible for,
and who is receiving, hospital or medical benefits under the State Medicaid
program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), or under
the NJ FamilyCare program established pursuant to P.L.2005, c.156 (C.30:4J-8 et
al.), as appropriate.

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

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

����� "Participating
health care provider" means a licensed or certified health care provider
who is registered to provide health care services to benefits recipients under
the State Medicaid or NJ FamilyCare programs, as appropriate.

����� "
Remote
patient monitoring devices" 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.2)

�������
4.� Section 1 of P.L.2017, c.117 (C.45:1-61) is
amended to read as follows:

����� 1.�
As used in P.L.2017, c.117 (C.45:1-61 et al.):

����� "Asynchronous
store-and-forward" means the acquisition and transmission of images,
diagnostics, data, and medical information either to, or from, an originating
site or to, or from, the health care provider at a distant site, which allows
for the patient to be evaluated without being physically present.

����� "Cross-coverage
service provider" means a health care provider, acting within the scope of
a valid license or certification issued pursuant to Title 45 of the Revised
Statutes, who engages in a remote medical evaluation of a patient, without in-person
contact, at the request of another health care provider who has established a
proper provider-patient relationship with the patient.

����� "Distant
site" means a site at which a health care provider, acting within the
scope of a valid license or certification issued pursuant to Title 45 of the
Revised Statutes, is located while providing health care services by means of
telemedicine or telehealth.

����� "Health
care provider" means an individual who provides a health care service to a
patient, and includes, but is not limited to, a licensed physician, nurse,
nurse practitioner, psychologist, psychiatrist, psychoanalyst, clinical social
worker, physician assistant, professional counselor, respiratory therapist,
speech pathologist, audiologist, optometrist, or any other health care
professional acting within the scope of a valid license or certification issued
pursuant to Title 45 of the Revised Statutes.

����� "On-call
provider" means a licensed or certified health care provider who is
available, where necessary, to physically attend to the urgent and follow-up
needs of a patient for whom the provider has temporarily assumed
responsibility, as designated by the patient's primary care provider or other
health care provider of record.

����� "Originating
site" means a site at which a patient is located at the time that health
care services are provided to the patient by means of telemedicine or
telehealth.

�����
"Remote
patient monitoring devices" means, but is not limited to, devices that
monitor clinical patient data such as weight, blood pressure, pulse oximetry,
respiratory flow rate, musculoskeletal system status, blood glucose levels, and
other patient-generated physiological data.

����� "Telehealth"
means the use of information and communications technologies, including
telephones, remote patient monitoring devices, or other electronic means, to
support clinical health care, provider consultation, patient and professional
health-related education, public health, health administration, and other
services in accordance with the provisions of P.L.2017, c.117 (C.45:1-61 et
al.).

����� "Telemedicine"
means the delivery of a health care service using electronic communications,
information technology, or other electronic or technological means to bridge
the gap between a health care provider who is located at a distant site and a
patient who is located at an originating site, either with or without the
assistance of an intervening health care provider, and in accordance with the
provisions of P.L.2017, c.117 (C.45:1-61 et al.).� "Telemedicine"
does not include the use, in isolation, of electronic mail, instant messaging,
phone text, or facsimile transmission.

����� "Telemedicine
or telehealth organization" means a corporation, sole proprietorship,
partnership, or limited liability company that is organized for the primary
purpose of administering services in the

furtherance of telemedicine or telehealth.

(cf:
P.L.2021, c.310, s.3)

����� 5.�
Section 2 of P.L.2017, c.117 (C.45:1-62) is amended to read as follows:

����� 2.�
a.� Unless specifically prohibited or limited by federal or State law, a health
care provider who establishes a proper provider-patient relationship with a
patient may remotely provide health care services to a patient through the use
of telemedicine.� A health care provider may also engage in telehealth
and
the use of remote patient monitoring devices
as may be necessary to support
and facilitate the provision of health care services to patients.� Nothing in
P.L.2017, c.117 (C.45:1-61 et al.) shall be construed to allow a provider to
require a patient to use telemedicine or telehealth
or remote patient
monitoring devices
in lieu of receiving services from an in-network
provider.

����� b.�
Any health care provider who uses telemedicine or engages in telehealth
or
the use of remote patient monitoring devices
while providing health care
services to a patient, shall:� (1) be validly licensed, certified, or
registered, pursuant to Title 45 of the Revised Statutes, to provide such
services in the State of New Jersey; (2) remain subject to regulation by the
appropriate New Jersey State licensing board or other New Jersey State
professional regulatory entity; (3) act in compliance with existing requirements
regarding the maintenance of liability insurance; and (4) remain subject to New
Jersey jurisdiction.

����� c.�
(1) Telemedicine services may be provided using interactive, real-time, two-way
communication technologies or, subject to the requirements of paragraph (2) of
this paragraph, asynchronous store-and-forward technology.

����� (2)
A health care provider engaging in telemedicine or telehealth
or

the
use of remote patient monitoring devices
may use asynchronous
store-and-forward technology to provide services with or without the use of
interactive, real-time, two-way audio if, after accessing and reviewing the
patient's medical records, the provider determines that the provider is able to
meet the same standard of care as if the health care services were being
provided in person and informs the patient of this determination at the outset
of the telemedicine or telehealth encounter.

����� (3)
(a) At the time the patient requests health care services to be provided using
telemedicine or telehealth
or remote patient monitoring devices
, the
patient shall be clearly advised that the telemedicine or telehealth encounter
,
including the use of remote patient monitoring devices,
may be with a
health care provider who is not a physician, and that the patient may
specifically request that the telemedicine or telehealth encounter be scheduled
with a physician.� If the patient requests that the telemedicine or telehealth
encounter
, including the use of remote patient monitoring devices,
be
with a physician, the encounter shall be scheduled with a physician.

����� (b)
The identity, professional credentials, and contact information of a health
care provider providing telemedicine or telehealth services
or using remote
patient monitoring devices
shall be made available to the patient at the
time the patient schedules services to be provided using telemedicine or
telehealth
or remote patient monitoring devices
, if available, or upon
confirmation of the scheduled telemedicine or telehealth encounter,
which
may include the use of remote patient monitoring devices,
and shall be made
available to the patient during and after the provision of services.� The
contact information shall enable the patient to contact the health care
provider, or a substitute health care provider authorized to act on behalf of
the provider who provided services, for at least 72 hours following the
provision of services.� If the health care provider is not a physician, and the
patient requests that the services be provided by a physician, the health care
provider shall assist the patient with scheduling a telemedicine or telehealth
encounter
, which may include the use of remote patient monitoring devices,

with a physician.

����� (4)
A health care provider engaging in telemedicine or telehealth
or

the
use of remote patient monitoring devices
shall review the medical history
and any medical records provided by the patient.� For an initial encounter with
the patient, the provider shall review the patient's medical history and
medical records prior to initiating contact with the patient, as required
pursuant to paragraph (3) of subsection a. of section 3 of P.L.2017, c.117
(C.45:1-63).� In the case of a subsequent telemedicine or telehealth encounter
,
including the use of remote patient monitoring devices,
conducted pursuant
to an ongoing provider-patient relationship, the provider may review the
information prior to initiating contact with the patient or contemporaneously
with the telemedicine or telehealth encounter.

����� (5)
Following the provision of services using telemedicine or telehealth
or
remote patient monitoring devices
, the patient's medical information shall
be entered into the patient's medical record, whether the medical record is a
physical record, an electronic health record, or both, and, if so requested to
by the patient, forwarded directly to the patient's primary care provider,
health care provider of record or any other health care providers as may be
specified by the patient.� For patients without a primary care provider or
other health care provider of record, the health care provider engaging in
telemedicine or telehealth
or the use of remote patient monitoring devices

may advise the patient to contact a primary care provider, and, upon request by
the patient, shall assist the patient with locating a primary care provider or
other in-person medical assistance that, to the extent possible, is located
within reasonable proximity to the patient.� The health care provider engaging
in telemedicine or telehealth
or the use of remote patient monitoring
devices
shall also refer the patient to appropriate follow up care where
necessary, including making appropriate referrals for in-person care or
emergency or complementary care, if needed.� Consent may be oral, written, or
digital in nature, provided that the chosen method of consent is deemed
appropriate under the standard of care.

����� d.�
(1) Any health care provider providing health care services using telemedicine
or telehealth
or remote patient monitoring devices
shall be subject to
the same standard of care or practice standards as are applicable to in-person
settings.� If telemedicine or telehealth services
or the use of remote
patient monitoring devices
would not be consistent with this standard of
care, the health care provider shall direct the patient to seek in-person care.

����� (2)
Diagnosis, treatment, and consultation recommendations, including discussions
regarding the risk and benefits of the patient's treatment options, which are
made through the use of telemedicine or telehealth
or remote patient
monitoring devices
, including the issuance of a prescription based on a
telemedicine or telehealth encounter
, including the use of remote patient
monitoring devices
, shall be held to the same standard of care or practice
standards as are applicable to in-person settings.� Unless the provider has
established a proper provider-patient relationship with the patient, a provider
shall not issue a prescription to a patient based solely on the responses
provided in an online static questionnaire.

����� (3)
In the event that a mental health screener, screening service, or screening
psychiatrist subject to the provisions of P.L.1987, c.116 (C.30:4-27.1 et seq.)
determines that an in-person psychiatric evaluation is necessary to meet
standard of care requirements, or in the event that a patient requests an
in-person psychiatric evaluation in lieu of a psychiatric evaluation performed
using telemedicine or telehealth, the mental health screener, screening
service, or screening psychiatrist may nevertheless perform a psychiatric
evaluation using telemedicine and telehealth if it is determined that the
patient cannot be scheduled for an in-person psychiatric evaluation within the
next 24 hours.� Nothing in this paragraph shall be construed to prevent a
patient who receives a psychiatric evaluation using telemedicine and telehealth
as provided in this paragraph from receiving a subsequent, in-person
psychiatric evaluation in connection with the same treatment event, provided
that the subsequent in-person psychiatric evaluation is necessary to meet
standard of care requirements for that patient.

����� e.�
The prescription of Schedule II controlled dangerous substances through the use
of telemedicine or telehealth shall be authorized only after an initial
in-person examination of the patient, as provided by regulation, and a
subsequent in-person visit with the patient shall be required every three
months for the duration of time that the patient is being prescribed the
Schedule II controlled dangerous substance.� However, the provisions of this
subsection shall not apply, and the in-person examination or review of a
patient shall not be required, when a health care provider is prescribing a
stimulant which is a Schedule II controlled dangerous substance for use by a
minor patient under the age of 18, provided that the health care provider is
using interactive, real-time, two-way audio and video technologies when
treating the patient and the health care provider has first obtained written
consent for the waiver of these in-person examination requirements from the
minor patient's parent or guardian.

����� f.�
A mental health screener, screening service, or screening psychiatrist subject
to the provisions of P.L.1987, c.116 (C.30:4-27.1 et seq.):

����� (1)
shall not be required to obtain a separate authorization in order to engage in
telemedicine or telehealth for mental health screening purposes; and

����� (2)
shall not be required to request and obtain a waiver from existing regulations,
prior to engaging in telemedicine or telehealth.

����� g.�
A health care provider who engages in telemedicine or telehealth
or the use
of remote patient monitoring devices
, as authorized by P.L.2017, c.117
(C.45:1-61 et al.), shall maintain a complete record of the patient's care, and
shall comply with all applicable State and federal statutes and regulations for
recordkeeping, confidentiality, and disclosure of the patient's medical record.

����� h.�
A health care provider shall not be subject to any professional disciplinary
action under Title 45 of the Revised Statutes solely on the basis that the
provider engaged in telemedicine or telehealth
or the use of remote patient
monitoring devices
pursuant to P.L.2017, c.117 (C.45:1-61 et al.).

����� i.�
(1) In accordance with the "Administrative Procedure Act," P.L.1968,
c.410 (C.52:14B-1 et seq.), the State boards or other entities that, pursuant
to Title 45 of the Revised Statutes, are responsible for the licensure,
certification, or registration of health care providers in the State, shall
each adopt rules and regulations that are applicable to the health care
providers under their respective jurisdictions, as may be necessary to
implement the provisions of this section and facilitate the provision of
telemedicine and telehealth services
, including the use of remote patient
monitoring devices
.� Such rules and regulations shall, at a minimum:

����� (a)
include best practices for the professional engagement in telemedicine and
telehealth
and the use of remote patient monitoring devices
;

����� (b)
ensure that the services patients receive using telemedicine or telehealth
or
remote patient monitoring devices
are appropriate, medically necessary, and
meet current quality of care standards;

����� (c)
include measures to prevent fraud and abuse in connection with the use of
telemedicine and telehealth
or remote patient monitoring devices
,
including requirements concerning the filing of claims and maintaining
appropriate records of services provided; and

����� (d)
provide substantially similar metrics for evaluating quality of care and
patient outcomes in connection with services provided using telemedicine and
telehealth
or remote patient monitoring devices
as currently apply to
services provided in person.

����� (2)
In no case shall the rules and regulations adopted pursuant to paragraph (1) of
this subsection require a provider to conduct an initial in-person visit with
the patient as a condition of providing services using telemedicine or
telehealth
or remote patient monitoring devices
.

����� (3)
The failure of any licensing board to adopt rules and regulations pursuant to
this subsection shall not have the effect of delaying the implementation of
this act, and shall not prevent health care providers from engaging in
telemedicine or telehealth
or the use of remote patient monitoring devices

in accordance with the provisions of this act and the practice act applicable
to the provider's professional licensure, certification, or registration.

(cf:
P.L.2021, c.310, s.4)

����� 6.�
Section 3 of P.L.2017, c.117 (C.45:1-63) is amended to read as follows:

����� 3.
a. Any health care provider who engages in telemedicine or telehealth
or the
use of remote patient monitoring devices
shall ensure that a proper
provider-patient relationship is established.� The establishment of a proper
provider-patient relationship shall include, but shall not be limited to:

����� (1)� properly
identifying the patient using, at a minimum, the patient's name, date of birth,
phone number, and address.� When properly identifying the patient, the provider
may additionally use the patient's assigned identification number, social
security number, photo, health insurance policy number, or other appropriate
patient identifier associated directly with the patient;

����� (2)� disclosing
and validating the provider's identity and credentials, such as the provider's
license, title, and, if applicable, specialty and board certifications;

����� (3)� prior
to initiating contact with a patient in an initial encounter for the purpose of
providing services to the patient using telemedicine or telehealth,
or
remote patient monitoring devices,
reviewing the patient's medical history
and any available medical records; and

����� (4)� prior
to initiating contact with a patient for the purpose of providing services to
the patient using telemedicine or telehealth,
or remote patient monitoring
devices,
determining whether the provider will be able to provide the same
standard of care using telemedicine or telehealth
or remote patient
monitoring devices
as would be provided if the services were provided in
person.� The provider shall make this determination prior to each unique
patient encounter.

����� b.�
Telemedicine or telehealth may be practiced
, or remote patient monitoring
devices may be used,
without a proper provider-patient relationship, as
defined in subsection a. of this section, in the following circumstances:

����� (1)� during
informal consultations performed by a health care provider outside the context
of a contractual relationship, or on an irregular or infrequent basis, without
the expectation or exchange of direct or indirect compensation;

����� (2)� during
episodic consultations by a medical specialist located in another jurisdiction
who provides consultation services, upon request, to a properly licensed or
certified health care provider in this State;

����� (3)� when
a health care provider furnishes medical assistance in response to an emergency
or disaster, provided that there is no charge for the medical assistance; or

����� (4)� when
a substitute health care provider, who is acting on behalf of an absent health
care provider in the same specialty, provides health care services on an
on-call or cross-coverage basis, provided that the absent health care provider
has designated the substitute provider as an on-call provider or cross-coverage
service provider.

(cf:
P.L.2017, c.117, s.3)

����� 7.�
Section 4 of P.L.2017, c.117 (C.45:1-64) is amended to read as follows:

����� 4.�
a.� Each telemedicine or telehealth organization operating in the State shall
annually register with the Department of Health.

����� b.�
Each telemedicine or telehealth organization operating in the State shall
submit an annual report to the Department of Health in a manner as determined
by the commissioner.� The annual report shall include de-identified encounter
data including, but not limited to: the total number of telemedicine and
telehealth encounters conducted; the type of technology utilized to provide
services using telemedicine or telehealth
or remote patient monitoring
devices
; the category of medical condition for which services were sought;
the geographic region of the patient and the provider; the patient's age and
sex; and any prescriptions issued.� The commissioner may require the reporting
of any additional information as the commissioner deems necessary and
appropriate, subject to all applicable State and federal laws, rules, and
regulations for recordkeeping and privacy.� Commencing six months after the
effective date of P.L.2017, c.117 (C.45:1-61 et al.), telemedicine and
telehealth organizations shall include in the annual report, for each
telemedicine or telehealth encounter: the patient's race and ethnicity; the
diagnostic codes; the evaluation management codes; and the source of payment
for the encounter.

����� c.�
The Department of Health shall compile the information provided in the reports
submitted by telemedicine and telehealth organizations pursuant to subsection
b. of this section to generate Statewide data concerning telemedicine and
telehealth services
, including the use of remote patient monitoring devices,

provided in the State.� The department shall annually share the Statewide data
with the Department of Human Services, the Department of Banking and Insurance,
the Telemedicine and Telehealth Review Commission established pursuant to
section 5 of P.L.2017, c.117 (C.45:1-65), State boards and other entities that,
under Title 45 of the Revised Statutes, are responsible for the professional
licensure, certification, or registration of health care providers in the State
who provide health care services using telemedicine or telehealth
or through
the use of remote patient monitoring devices
pursuant to P.L.2017, c.117
(C.45:1-61 et al.), and the Legislature pursuant to section 2 of P.L.1991,
c.164 (C.52:14-19.1).� The department shall also transmit a report to the
Legislature and the Telemedicine and Telehealth Review Commission that includes:
an analysis of each rule and regulation adopted pursuant to subsection i. of
section 2 of P.L.2017, c.117 (C.45:1-62) by a State board or other entity
responsible for the professional licensure, certification, or registration of
health care providers in the State who provide health care services using
telemedicine or telehealth
or through the use of remote patient monitoring
devices
; and an assessment of the effect that telemedicine and telehealth
and
the use of remote patient monitoring devices
is having on health care
delivery, health care outcomes, population health, and in-person health care
services provided in facility-based and office-based settings.�

����� d.�� A
telemedicine or telehealth organization that fails to register with the
Department of Health pursuant to subsection a. of this section or that fails to
submit the annual report required pursuant to subsection b. of this section
shall be liable to such disciplinary actions as the Commissioner of Health may
prescribe by regulation.

(cf:
P.L.2017, c.117, s.4)

����� 8.�
Section 5 of P.L.2017, c.117 (C.45:1-65) is amended to read as follows:

����� 5.�
a.� Six months after the effective date of P.L.2017, c.117 (C.45:1-61 et al.),
there shall be established in the Department of Health the Telemedicine and
Telehealth Review Commission, which shall review the information reported by
telemedicine and telehealth organizations pursuant to subsection b. of section
4 of P.L.2017, c.117 (C.45:1-64) and make recommendations for such executive,
legislative, regulatory, administrative, and other actions as may be necessary
and appropriate to promote and improve the quality, efficiency, and
effectiveness of telemedicine and telehealth services
, including the use of
remote patient monitoring devices,
provided in this State.

����� b.�
The commission shall consist of seven members, as follows: the Commissioner of
Health, or a designee, who shall serve ex officio, and six public members, with
two members each to be appointed by the Governor, the Senate President, and the
Speaker of the General Assembly.� The public members shall be health care
professionals with a background in the provision of health care services using
telemedicine and telehealth.� The public members shall serve at the pleasure of
the appointing authority, and vacancies in the membership shall be filled in
the same manner as the original appointments.�

����� c.�
Members of the commission shall serve without compensation but may be
reimbursed for necessary travel expenses incurred in the performance of their
duties within the limits of funds made available for that purpose.

����� d.�
The members shall select a chairperson and a vice chairperson from among the
members.� The chairperson may appoint a secretary, who need not be a member of
the commission.� The Department of Health shall provide staff and
administrative support to the commission.

����� e.�
The commission shall meet at least twice a year and at such other times as the
chairperson may require.� The commission shall be entitled to call to its
assistance and avail itself of the services of the employees of any State,
county, or municipal department, board, bureau, commission, or agency as it may
require and as may be available for its purposes.

����� f.�
The commission shall report its findings and recommendations to the Governor,
the Commissioner of Health, the State boards or other entities that, pursuant
to Title 45 of the Revised Statutes, are responsible for the licensure,
certification, or registration of health care providers in the State who
provide health care services using telemedicine or telehealth
or remote
patient monitoring devices
pursuant to P.L.2017, c.117 (C.45:1-61 et al.),
and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), the Legislature
no later than two years after the date the commission first meets. The
commission shall expire upon submission of its report.

(cf:
P.L.2017, c.117, s.5)

����� 9.�
Section 9 of P.L.2107, c. 117 (C.52:14-17.29w) is amended to read as follows:

����� 9.�
a.� The State Health Benefits Commission shall ensure that every contract
purchased thereby, which provides hospital and medical expense benefits,
additionally provides coverage and payment for health care services delivered
to a covered person through telemedicine or telehealth,
or through the use
of remote patient monitoring devices,
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 contract 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 health benefits contract purchased by the State Health Benefits Commission
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,
or through remote patient monitoring devices,

in an amount that exceeds the deductible, copayment, or coinsurance amount that
is applicable to an in-person consultation.� In no case shall a health benefits
contract purchased by the State Health Benefits Commission:

����� (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 remote patient monitoring devices,
or on the location or setting of the
originating site where the patient is located when receiving services using
telemedicine and telehealth,
or remote patient monitoring devices,

except to ensure that the services provided using telemedicine and telehealth
or
remote patient monitoring devices
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,
or remote
patient monitoring devices,
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,
or
remote patient monitoring devices,
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 health benefits contract 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
the State Health Benefits Commission, or a contract purchased thereby, to
require a covered person to use telemedicine or telehealth
or remote patient
monitoring devices
in lieu of receiving an in-person service from an
in-network provider.

����� d.�
The State Health Benefits Commission 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).

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

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

�����
"Remote
patient monitoring devices" 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.5)

����� 10.�
Section 10 of P.L.2017, c.117 (C.52:14-17.46.6h) is amended to read as follows:

����� 10.�
a.� The School Employees' Health Benefits Commission shall ensure that every
contract purchased thereby, which provides hospital and medical expense
benefits, additionally provides coverage and payment for health care services
delivered to a covered person through telemedicine or telehealth,
or through
the use of remote patient monitoring devices,
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 contract 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 health benefits contract purchased by the School Employees' Health Benefits
Commission 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,
or through the use of remote patient
monitoring devices,
in an amount that exceeds the deductible, copayment, or
coinsurance amount that is applicable to an in-person consultation.� In no case
shall a health benefits contract purchased by the School Employees' Health
Benefits Commission:

����� (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 remote patient monitoring devices,
or on the location or setting of the
originating site where the patient is located when receiving services using
telemedicine and telehealth,
or remote patient monitoring devices,

except to ensure that the services provided using telemedicine and telehealth
or
remote patient monitoring devices
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,
or remote patient
monitoring devices,
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,
or
remote patient monitoring devices,
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 health benefits contract 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
the School Employees' Health Benefits Commission, or a contract purchased
thereby, to require a covered person to use telemedicine or telehealth
or
remote patient monitoring
devices in lieu of receiving an in-person service
from an in-network provider.

����� d.�� The
School Employees' Health Benefits Commission 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).

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

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

�����
"Remote
patient monitoring devices" 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.6)

���� 11.� The Commissioner of Human
Services shall apply for such State plan amendments or waivers as may be
necessary to implement the provisions of this act and to secure federal
financial participation for State Medicaid expenditures under the federal Medicaid
program.

���� 12.� The Commissioner of Human
Services, pursuant to the "Administrative Procedure Act," P.L.1968,
c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to
implement the provisions of this act.

���� 13.� This act shall take
effect on the first day of the fourth month next following the date of
enactment, but the Commissioner of Human Services may take such anticipatory
administrative action in advance thereof as may be necessary for the
implementation of this act.

STATEMENT

����� This bill authorizes a health
care provider acting within the scope of a valid license, certification, or
registration issued pursuant to Title 45 of the Revised Statutes to engage in
the use of remote patient monitoring devices.

����� Currently, under the
provisions of P.L.2017, c.117 (C45:1-61 et al.) health care providers acting
within the scope of a valid license, certification, or registration issued
pursuant to Title 45 of the Revised Statutes are authorized to engage in the
use of telemedicine and telehealth but are not authorized to engage in the use
of remote patient monitoring devices.� This bill amends the provisions of
P.L.2017, c.117 (C45:1-61 et al.) to authorize health care providers to engage
in the use of remote patient monitoring devices to provide health care services
to a patient.

���� As used in the bill, �remote
patient monitoring devices� means, but is not limited to, devices that monitor
clinical patient data such as weight, blood pressure, pulse oximetry,
respiratory flow rate, musculoskeletal system status, blood glucose levels, and
other patient-generated physiological data.

���� The bill specifies that
Medicaid, NJ FamilyCare, and various insurance coverage providers (including
carriers of managed care plans, the State Health Benefits Commission, and the
School Employees� Health Benefits Commission) are each to provide coverage of
and payment for services provided through the use of remote patient monitoring
devices, at least at the same rate that is applicable when the services are
delivered through in-person contact or consultation.

���� The bill also provides that
coverage under the State Medicaid program include benefits for expenses
incurred for the remote patient monitoring device of a pregnant patient.