Bill
A 3699
Requires coverage parity for remote patient monitoring (RPM) across insurers and Medicaid/NJ FamilyCare, expands telehealth to include RPM, and bans extra cost-sharing.
Note on title: The bill file lists an unrelated title about motor vehicle repair shops. The text of A-3699 (1R) and committee statement instead address remote patient monitoring. This summary uses the bill text and committee materials related to remote patient monitoring.
Purpose
- To authorize and require coverage for health care services delivered through remote patient monitoring (RPM) devices, expand the statutory telehealth/telemedicine framework to include RPM, and direct insurers (including Medicaid/NJ FamilyCare and certain state employee plans) to reimburse RPM services on parity with in-person services.
Key provisions
- Adds “remote patient monitoring devices” to the telemedicine/telehealth provisions of P.L.2017, c.117 (C.45:1-61 et seq.) and incorporates RPM into the insurance coverage parity rules.
- Definition: “Remote patient monitoring devices” includes, but is not limited to, devices that monitor clinical patient data such as weight, blood pressure, pulse oximetry, respiratory flow rate, musculoskeletal status, blood glucose levels, and other patient-generated physiological data.
- Coverage and reimbursement parity: Carriers offering health benefits plans (including managed care plans, the State Health Benefits Commission, the School Employees’ Health Benefits Commission) and Medicaid/NJ FamilyCare must provide coverage and payment for services delivered via RPM at least at the same provider reimbursement rate that applies when those services are delivered in person, provided the services are otherwise covered.
- Cost-sharing limits: Carriers may not impose a deductible, copayment, or coinsurance for services delivered via telemedicine, telehealth, or RPM that exceeds the amount applicable to the equivalent in-person service.
- Restrictions prohibited: Carriers may not (a) impose location or setting restrictions on distant/originating sites for providers or patients when services use telemedicine/telehealth/RPM except to ensure the same standard of care; (b) restrict which electronic/technological platforms may be used, provided the platform allows meeting the in‑person standard of care and complies with federal privacy rules (45 CFR Parts 160 and 164); (c) deny coverage or reimbursement for routine patient monitoring via telehealth/RPM if in‑person coverage would be available; or (d) limit coverage to specific third‑party telemedicine organizations.
- Carrier limits preserved: Carriers may still limit services to those that are medically necessary and cannot force a covered person to use telehealth/RPM instead of an available in‑network in‑person visit.
- Medicaid specifics: The bill amends the State Medicaid statute (P.L.1968, c.413) to incorporate RPM-related coverage; the committee statement indicates Medicaid/NJ FamilyCare must cover and pay for services provided through RPM and that benefits include expenses for an RPM device for a pregnant patient.
- Regulatory implementation: The Commissioner of Banking and Insurance is to adopt implementing rules and regulations under the Administrative Procedure Act.
Committee action and amendments
- Introduced Feb 12, 2024; reported favorably with committee amendments by the Assembly Aging and Human Services Committee Jan 23, 2025; referred to Assembly Health Committee; later recorded as referred to Transportation (Jan 30, 2025).
- Committee amendments removed narrower language that had limited RPM for pregnant patients unable to access in‑person care and broadened the bill to define RPM and require coverage parity across payers as described above.
Who is affected
- Patients statewide, including Medicaid/NJ FamilyCare enrollees and pregnant patients (for device expenses as noted).
- Licensed health care providers acting within the scope of Title 45 professional licenses.
- Health insurers, managed care organizations, State Health Benefits Commission, School Employees’ Health Benefits Commission, and the Department of Banking and Insurance (rulemaking).
- Makers/suppliers of RPM devices and telehealth platform vendors (potentially increased demand).
Potential impact
- Increases access to remote monitoring services and continuity of care for patients who benefit from physiologic data collection outside clinical settings.
- Financial impact on payers due to required coverage/reimbursement parity; could incentivize broader clinical use of RPM by providers.
- Raises implementation issues around privacy/security, reimbursement administration, device eligibility, and clinical standards that will be addressed in rulemaking.
Sponsors and related bills
- Primary sponsor: Asm. George Alvarez; cosponsors: Karines Reyes, Manny De Los Santos.
- Companion/related bills: S-4358, S-2329; prior-session A-6951.
Status
- As of Jan 30, 2025: REFERRED TO TRANSPORTATION (most recent referral recorded after committee report).
Compiled from official sources — confirm details with the bill’s official record.
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