Read the full stored bill text
S3947 1R FISCAL ESTIMATE
LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
SENATE, No. 3947
STATE OF NEW JERSEY
222nd LEGISLATURE
DATED: JULY 6, 2026
SUMMARY
Synopsis:
Extends certain pay parity regarding telemedicine and
telehealth.
Type of Impact:
Eighteen month State expenditure and revenue increases.
Agencies Affected:
Department of Human Services, Department of the Treasury,
Department of Banking and Insurance.
Office of
Legislative Services Estimate
Fiscal Impact
18 Month Duration of Extension
State Expenditure Increase
Indeterminate
State Revenue Increase
Indeterminate
�
The Office of Legislative Services (OLS) concludes that the bill
will result in an indeterminate 18-month increase in State expenditures and
revenues. �NJ FamilyCare expenditures will increase by an indeterminate amount
to extend by 18 months the statutory requirement that NJ FamilyCare reimburse
for telemedicine and telehealth services at a rate that equals the provider
rate paid when the same services are delivered on an in-person basis, provided
the services are otherwise covered when delivered in person in the State.
�
Any increase in NJ FamilyCare expenditures will result in
additional State revenues, in the form of federal reimbursements for eligible
State expenditures under the federal Medicaid program.
BILL DESCRIPTION
����� The bill amends P.L.2021, c.310 to extend the
expiration date, from July 1, 2026 until December 31, 2027, of the requirement
that health benefits plans in the State cover and pay for health care services
delivered to a covered person through telemedicine or telehealth at a provider
reimbursement rate that equals the provider reimbursement rate that is
applicable, when the services are delivered through in-person contact and
consultation in New Jersey, provided the services are otherwise covered by the
health benefits plan when delivered through in-person contact and consultation
in the State.
FISCAL ANALYSIS
EXECUTIVE BRANCH
����� None received.
OFFICE OF LEGISLATIVE SERVICES
����� The OLS concludes that the bill will result in an
indeterminate 18-month increase in State expenditures and revenues. �NJ
FamilyCare expenditures, in the form of monthly capitation payments to
State-contracted Medicaid managed care organizations for the cost of services
delivered to NJ FamilyCare enrollees, will increase by an indeterminate amount
to extend by 18 months the requirement, under P.L.2021, c.310, that NJ
FamilyCare reimburse for telemedicine and telehealth services at a provider
rate that equals the rate paid when the same services are delivered on an
in-person basis, provided the services are otherwise covered when delivered in
person in the State.� Given that approximately 95 percent of NJ FamilyCare
participants are enrolled with a Medicaid managed care organization, and the
specific reimbursement rates paid by each managed care organization to
contracted providers of telemedicine and telehealth services are proprietary,
the OLS lacks the informational basis to determine the magnitude of the NJ
FamilyCare cost increase under the bill.
����� The telemedicine and telehealth rate parity
requirement was originally established under P.L.2021, c.310.� The end date for
the telemedicine and telehealth rate parity requirement has been extended
twice, most recently by P.L.2024, c.105 to July 1, 2026.� If this requirement
were to expire at the start of FY 2027, NJ FamilyCare would reimburse for
telemedicine and telehealth services at a rate that does not exceed, but is not
necessarily equal to, the rate at which such services would be paid if provided
during an in-person encounter in the State.
����� Increased State expenditures for NJ FamilyCare
capitation payments to the Medicaid managed care organizations will be eligible
for additional federal Medicaid cost reimbursements, thereby increasing State
revenues, albeit by an indeterminate amount.
����� The OLS anticipates that extending provider rate
parity for telemedicine and telehealth services by 18 additional months will
have no fiscal impact on Department of the Treasury expenditures for the State
Health Benefits Program and the School Employees� Health Benefits Program,
which are required under P.L.2024, c.105 to have rate parity for telemedicine
and telehealth services through July 1, 2026.� Both programs reinstated
cost-sharing requirements, as of February 2022, for telemedicine and telehealth
visits, which had been suspended during the State and federal public health
emergencies declared in response to COVID-19.� Absent the provisions of
P.L.2024, c.105, the programs would reimburse for telemedicine and telehealth
services at a provider rate that does not exceed the rate paid for services
delivered on an in-person basis.
����� The OLS, further, concludes that the Department of
Banking and Insurance will not incur any additional costs under the provisions
of the bill.
Section:
Human Services
Analyst:
Anne Cappabianca
Senior Fiscal Analyst
Approved:
Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the
Office of Legislative Services due to the failure of the Executive Branch to
respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980,
c.67 (C.52:13B-6 et seq.).