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A 3853

Extends certain pay parity regarding telemedicine and telehealth until July 1, 2026.*

2024-2025 Regular Session Introduced by John Azzariti and 20 co-sponsors

Extends NJ telemedicine pay parity to July 1, 2026, requiring plans to reimburse telehealth the same as in-person when covered, with limited audio-only and behavioral health rules.

Approved P.L.2024, c.105.
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Bill Summary · A 3853

Summary — A3853 (P.L.2024, c.105)

Purpose

A3853 extends New Jersey’s temporary “telemedicine/telehealth pay parity” requirement so that, through July 1, 2026, health benefits plans must generally reimburse telemedicine and telehealth services at the same rate as equivalent in‑person services when those services are covered in person.

Key provisions

  • Amends section 11 of P.L.2021, c.310 to change the parity end date to July 1, 2026.
  • Requires a health benefits plan issued or delivered in New Jersey to provide coverage and payment for services delivered via telemedicine or telehealth at a provider reimbursement rate equal to the rate applicable when the same service is delivered in person in New Jersey — provided the service is covered in person.
  • Explicitly includes carriers, contracts purchased by the State Health Benefits Commission and School Employees’ Health Benefits Commission, the State Medicaid program, and NJ FamilyCare within the definition of “health benefits plan.”
  • Establishes exceptions and special rules (see below).

Exceptions and special rules

  • The parity requirement does not apply to telemedicine/telehealth organizations that do not provide the service on an in‑person basis in New Jersey.
  • For physical health services provided via real‑time, two‑way audio without video (including audio‑only telephone), reimbursement is contract‑determined; however, audio‑only physical services must be reimbursed at least 50% of the in‑person rate.
  • The 50% minimum does NOT apply to behavioral health services delivered via audio‑only: those behavioral health services must be reimbursed at the same rate as in‑person services.

Who is affected

  • Private insurers and health plans issued/delivered in New Jersey.
  • State programs: State Health Benefits Program, School Employees’ Health Benefits Program, NJ Medicaid and NJ FamilyCare.
  • Providers of telemedicine/telehealth services (including behavioral health providers).
  • Telemedicine organizations that do not offer in‑person services in NJ are exempt.

Fiscal impact

  • The Office of Legislative Services (OLS) estimates an indeterminate increase in State expenditures and corresponding indeterminate increases in State revenues (federal Medicaid match) for the duration of the extension. The primary fiscal effect is an increase in NJ FamilyCare capitation payments; precise magnitude is unknown because managed care reimbursement arrangements are proprietary.
  • OLS expects no additional cost to the Department of Banking and Insurance.

Timeline and procedural status

  • Enacted: Approved December 31, 2024 — Chapter 105 (P.L.2024, c.105); effective immediately.
  • The statutory pay‑parity window is now from the effective date of P.L.2021, c.310 through July 1, 2026.
  • Legislative votes: Assembly 72–1–0 (12/19/2024); Senate 38–0 (12/19/2024).

Sponsors and related bills

  • Primary sponsor: Asw. Jaime R. Williams; cosponsors include Michael Novakhov, Joe DeStefano, Steven Otis, David McDonough, Karl Brabenec, Lester Chang.
  • Companion: S2988.
  • Prior-session related bills: A1288, A7583.

This law temporarily preserves rate parity for most telemedicine/telehealth services in New Jersey through July 1, 2026 while creating limited exemptions (notably for audio‑only physical services and providers without in‑person services in the State) and a parity carve‑out for behavioral health audio‑only services.

Compiled from official sources — confirm details with the bill’s official record.

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