This bill mandates that health benefits plans and carriers in New Jersey adhere to specific requirements regarding network adequacy and access to mental health care. It defines key terms such as "carrier," "covered person," and "mental health provider," and establishes that a health benefits plan must ensure that 100% of covered persons have access to in-network mental health providers who can deliver services in person within 15 miles of their residence and within 30 days of a request. If in-person services are unavailable, the plan must provide access to mental health services through telemedicine or telehealth, also within a 30-day timeframe.
Additionally, the bill stipulates that carriers must cover out-of-network mental health services delivered via telemedicine or telehealth at the same reimbursement rate as in-person services, with payments directed to either the individual practitioner or their employing organization. It prohibits carriers from imposing higher deductibles, copayments, or coinsurance for telehealth services compared to in-person consultations. The bill also outlines penalties for non-compliance and requires the Commissioners of Banking and Insurance and Human Services to adopt necessary regulations to implement these provisions.