"Breann's Law" (Bill A-2822) requires health insurers, the State Health Benefits Program, and NJ FamilyCare to cover out-of-network medical services for children diagnosed with catastrophic illnesses - defined as life-threatening conditions or those posing serious disability risks - when services are provided by referral from an in-network provider. The law mandates that coverage for these out-of-network services must be provided at the same level as in-network care under the same health plan. It applies to specific health insurance contracts, including hospital service, medical service, health service corporation plans, and group health insurance policies issued in New Jersey. This policy change directly affects families of children with severe illnesses who previously faced barriers to accessing specialized care outside their insurance network.
This New Jersey Assembly Resolution (AR 26) urges Congress to remove marijuana from Schedule I of the federal Controlled Substances Act. It directly affects medical marijuana patients and businesses in New Jersey (and 37 other states) who face barriers due to federal classification, including lack of insurance coverage, banking restrictions, and high costs ($350-$500 monthly for patients). The resolution highlights that marijuana's Schedule I status conflicts with its accepted medical use in many states and scientific evidence of health benefits. It seeks to protect public safety by ending federal restrictions that force dispensaries to handle large cash amounts, increasing crime risks. The bill does not change current law but calls for congressional action to align federal policy with state legalization.
This New Jersey bill (A1571) requires health insurance companies to cover diagnosis and treatment for autism and certain developmental disabilities. It directly affects health insurers operating in New Jersey and individuals with these conditions, mandating coverage for screening, diagnosis, and therapies like speech, occupational, and physical therapy without denying benefits based on "non-restorative" treatment. The bill sets annual benefit limits ($36,000 in 2011, adjusted yearly after 2012 for inflation) and requires treatment plans specifying therapies, frequency, and goals. It clarifies that coverage doesn’t replace school-based services but ensures insurance pays for related costs.
This bill (A4270) requires Medicaid programs and health insurance carriers in New Jersey to give participating healthcare providers at least six months' written notice before changing policies that could lead to denial of coverage for services provided to patients. It directly affects doctors, clinics, and other healthcare providers who contract with Medicaid or private health plans. The key provision mandates that carriers must notify providers well in advance of any policy changes impacting coverage eligibility, ensuring providers have time to adjust. This applies to all managed care plans under New Jersey's Medicaid program, FamilyCare Health Coverage, and authorized health insurers.
This bill requires health insurance companies in New Jersey to cover lead screenings for all children 16 years of age or younger. It mandates that healthcare providers (including doctors, nurses, and facilities serving children) perform these screenings unless parents object in writing, and follow up with families if elevated lead levels are detected. The Department of Health must establish regulations based on CDC guidelines, including screening schedules, follow-up protocols, and public education campaigns about lead poisoning risks. The law directly affects children under 16, their families, healthcare providers, and health insurers.
This bill (S 3477) requires health insurance carriers in New Jersey - including Medicaid, private plans, and self-funded employer plans - to ensure mental health care access for all covered individuals. It mandates that carriers maintain sufficient mental health providers in their networks, guaranteeing 100% of enrollees can access in-person care within 15 miles and 30 days, or telehealth/telemedicine care within 30 days if in-person options are unavailable. Insurers must cover telehealth mental health services on the same terms as in-person visits, with no higher deductibles/copays and reimbursement rates at least matching Medicaid rates. The law applies to all health benefits plans (excluding accident-only, disability, or workers' compensation coverage) and establishes penalties for noncompliance.
New Jersey bill A 1775 requires health insurers (including hospital, medical, and health service corporations) to cover counseling and behavioral therapies for anyone receiving medication-assisted treatment (MAT) for opioid addiction. The bill mandates that this coverage be provided under the same terms and conditions as other medical treatments, prohibiting stricter limits on mental health/substance use disorder benefits compared to general medical care. It directly affects insured individuals seeking treatment for substance use disorders and requires insurers to comply with federal mental health parity standards. The law would apply to all health insurance contracts issued or renewed in New Jersey after its effective date.
This bill requires most health insurance plans in New Jersey to cover annual physical examinations for student athletes (and camp participants) as a preventive health service, similar to other routine check-ups. It applies to hospital service corporations, medical service corporations, health insurers, health maintenance organizations, and state health benefit plans. The coverage must be provided at no additional cost to the student or family, as part of standard preventive care under the insurance contract. The law takes effect 120 days after enactment, applying to policies issued or renewed after that date.
This bill (A 3412) provides lifetime health insurance coverage for live kidney donors in New Jersey. It requires the state to pay all premiums for a gold-level health plan through the New Jersey Individual Health Coverage Program, covering the donor for life with prescription drug coverage. The coverage is funded entirely by the newly established "Kidney Donor Insurance Fund" in the Department of Banking and Insurance, eliminating any cost to the donor or their employer. The bill applies to all live kidney donations occurring on or after its effective date.
This bill prohibits New Jersey health insurance companies and health plans from using a person's body weight to decide whether to cover treatment for eating disorders. It directly affects individuals seeking eating disorder care by ensuring coverage decisions aren't based on weight, which can prevent discrimination in treatment access. The law requires insurers to cover medically necessary treatments without considering weight as a factor, applying to all health plans delivered or renewed after the effective date. It takes effect 90 days after enactment, with "carrier" defined to include all authorized health insurers in the state.
