Gopal Joins Downey to Sponsor Bill Requiring Insurance Companies to Cover Telehealth

06/09/20 | News

OCEAN TOWNSHIP—Senator Vin Gopal today joined Assemblywoman Joann Downey in sponsoring legislation that would require all New Jersey health benefits plans, Medicaid and NJ FamilyCare, and the State Health Benefits Programs (SHBP) and School Employees’ Health Benefits Program (SEHBP) to provide expanded coverage for services provided using telemedicine and telehealth.

Specifically, the bill would require all health insurance plans to reimburse medical providers for telehealth or telemedicine services with the same amount that they would receive for providing the same services in person.

The bill also prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from imposing “place of service” requirements on services provided using telemedicine and telehealth, and expressly allows licensed health care providers to provide services using telemedicine and telehealth.

The bill prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from placing restrictions on the electronic or technological platform used to provide telemedicine and telehealth, so long as the services provided when using that platform would meet the in-person standard of care for that service, and if the platform is otherwise compliant with the requirements of certain federal health privacy rules.

“Telemedicine is medicine—and for many New Jerseyans, it’s one of the best options they’ve got,” said Gopal (D-Long Branch). “We can’t let bureaucratic red tape and old ways of thinking obstruct new ways of delivering healthcare services. This pandemic has been a case study in how effective—and, in many cases, how much more accessible—telehealth and telemedicine can be for New Jerseyans who need it. Let’s end the discrimination against virtual care and make sure that everyone can get coverage for the medical services they need.”

“If a doctor can provide the same quality of services virtually that they can in person, there’s no reason for insurance plans to discriminate by lowering that doctor’s reimbursement,” said Downey (D-Freehold). “We’ve seen throughout this pandemic that many services can be provided equally well through virtual means, often at lower cost or greater convenience to all parties involved. This can be especially meaningful for seniors or patients with disabilities, who can face real challenges when finding transportation to a doctor’s office. It’s time to move past an outdated model that punishes innovation and technology, and create a new paradigm that rewards efficiency and accessibility.”