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S 3947

Extends certain pay parity regarding telemedicine and telehealth.*

2026-2027 Regular Session Introduced by Rosy Bagolie and 8 co-sponsors

Extends and expands parity for telemedicine reimbursement and access in New Jersey, ensuring telehealth is paid the same as in-person care with limited exceptions.

Approved P.L.2026, c.29.
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Bill Summary · S 3947

Summary of Bill S.3947 (Session 222, New Jersey)

Purpose and Intent

  • The bill extends and expands pay parity and coverage parity for telemedicine and telehealth services in New Jersey.
  • It builds on existing telemedicine/telehealth reimbursement requirements to ensure equivalent provider payment rates and to remove certain barriers, with specific temporary extensions and broader accessibility considerations.

Key Provisions and Changes

  • Reimbursement Parity with In-Person Services (current framework, amended)

    • Carriers offering a health benefits plan in New Jersey must provide coverage and payment for telemedicine/telehealth services on the same basis as in-person services in New Jersey, provided the services are otherwise covered for in-person care.
    • Reimbursements may be made to the individual practitioner or the employing agency/organization.

  • Network and Cost-Sharing Rules

    • Carriers may limit coverage to in-network providers but must not impose deductibles, copayments, or coinsurance for telemedicine/telehealth that exceed those for in-person services.
    • In brief, telemedicine should not be financially penalized relative to in-person care.

  • Site Location and Platform Flexibility (protects access and standard of care)

    • No restrictions on the patient’s originating site or the distant site used by the provider, beyond ensuring the standard of care is equivalent to in-person care.
    • Providers may use any electronic/technological platform (including real-time audio, with or without video, and combinations with store-and-forward) to deliver telemedicine/telehealth.
    • The platform must meet the standard of care and comply with federal privacy rules (45 CFR Parts 160 and 164).

  • Routine Monitoring and Remote Services

    • Coverage must include routine patient monitoring via telemedicine/telehealth (e.g., remote vital signs and status check-ins) when those services would be covered if delivered in person and the provider can meet the same standard of care.

  • Limitations and Exceptions (new and existing)

    • Does not require coverage for services provided by telemedicine/telehealth organizations that do not offer in-person services in New Jersey.
    • Does not apply to physical health services delivered via audio-only (no video) in real time.
    • Behavioral health services delivered via audio-only (no video) must be reimbursed at the in-person rate.

  • Regulatory Authority

    • The Commissioner of Banking and Insurance is tasked with adopting rules and regulations to implement these provisions.

  • Definitions

    • Retains and clarifies definitions for terms such as telemedicine, telehealth, asynchronous store-and-forward, distant site, originating site, carrier, covered person, and health benefits plan.

  • Effective Reimbursement Period (current text)

    • The bill includes a timeline for reimbursement parity extending previously granted limits. Specifically, the act as amended would provide telemedicine/telehealth reimbursement parity for a defined period, with a renewal/extension to December 31, 2027 (the current version extends beyond the prior July 1, 2026 date).

Affected Parties

  • Covered Persons/Beneficiaries

    • Individuals enrolled in health benefit plans in New Jersey who receive telemedicine or telehealth services.

  • Carriers and Health Benefits Plans

    • Insurance companies, health service corporations, hospital service corporations, medical service corporations, and HMOs issuing plans in New Jersey.
    • State programs included: Medicaid, NJ FamilyCare, and plans purchased by the State Health Benefits Commission or School Employees' Health Benefits Commission.

  • Healthcare Providers

    • Physicians and other practitioners delivering telemedicine/telehealth services, whether in-person or via telemedicine platforms.

  • Telemedicine/Telehealth Organizations

    • Entities that provide telemedicine/telehealth services (subject to the in-person coverage exception if they do not provide in-person services in New Jersey).

Timelines and Procedural Details

  • Effective Period (Section 11 amendments)

    • The reformulated parity coverage applies from the effective date of P.L.2021, c.310 through:
    • December 31, 2027 (extended from prior July 1, 2026 date).

  • Regulatory Adoption

    • The Commissioner of Banking and Insurance must adopt implementing regulations under the Administrative Procedure Act.

  • New Section Additions

    • The bill creates and amends sections to codify the parity requirements and define terms consistently.

Practical Implications

  • Telemedicine and telehealth services should be reimbursed at the same rate and under the same terms as equivalent in-person services, with limited exceptions.
  • Patients should face no higher out-of-pocket costs for telemedicine when such services would be covered in person.
  • Behavioral health services delivered via audio-only platforms must be reimbursed at the in-person rate, signaling stronger parity for mental health care.
  • The expansion clarifies platform flexibility and location-agnostic service delivery, provided quality of care and privacy standards are met.

Note: This summary reflects the Senate’s first reprint as reported with amendments on June 11, 2026.

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

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