Senate Committee Passes Legislation to Revise Current Health Standards

Trenton – In an effort to ensure areas within the medical field have equal standards across the board, the Senate Budget and Appropriations Committee today passed legislation that will eradicate existing disparities.

The first bill, S-2559, sponsored by Senators Vin Gopal and Nia Gill, would specifically require that reimbursement for telemedicine and telehealth services be equal to the reimbursement rate for the same services when they are provided in person.

“Due to the COVID-19 pandemic affecting both patients and doctors’ abilities to attend in person medical visits, many have turned to telehealth to conduct appointments,” said Senator Gopal (D-Monmouth). “These appointments have proved to be not only beneficial, but highly efficient, and it is imperative that we ensure that these virtual appointments are equal to those that are held in person. We must make sure there is ‘pay parity,’ being incorporated for services rendered.”

Under current law, telemedicine and telehealth services may be reimbursed up to the amount at which that service would be reimbursed if provided in person. In effect, this means carriers can negotiate reimbursement rates that are sometimes less than the in-person rate for services performed via telemedicine and telehealth. This legislation would prohibit that from happening and codify so-called “pay parity” in such instances.

“The state of New Jersey has been hit hard by this pandemic, and the last year has only highlighted the disparities that exist in access to healthcare,” said Senator Gill (D-Essex/Passaic). “Telehealth technology and services will help to ensure reimbursement is on par with that of in-person services which will ease some of the stress and issues that currently exist. This legislation will allow greater access to preventive health services and treatment through telehealth, expanding access for those who might be unable to receive it or might not otherwise seek care.”

The second bill, S-3000, sponsored by Senator Loretta Weinberg, would codify and establish enhanced network adequacy standards for pediatric primary and specialty care within the Medicaid program.

“Currently, all managed care organizations under the Medicaid program are required to ensure that 90 percent of enrollees are within six miles of two primary care providers in urban counties, and 85 percent are within 15 miles within non-urban counties,” said Senator Weinberg (D-Bergen). “This bill would revise these standards to ensure enrollees are within a smaller geographic radius to the closest primary care provider.”

The bill would additionally revise network adequacy standards for pediatric medical specialists, including pediatric oncologists and developmental and behavioral pediatricians.

Both bills cleared committee with votes of 12-0.