This New Jersey bill requires health insurers to cover colorectal cancer screenings for all covered individuals aged 33 and older, as well as for those under 33 if their doctor deems it medically necessary. The law mandates that these screenings follow the most recent guidelines from the United States Preventive Services Task Force and must be provided without any deductibles, copayments, or other out-of-pocket costs. Additionally, the bill ensures that if a non-colonoscopy screening test returns a positive result, the subsequent colonoscopy is also fully covered. These changes apply to various types of health insurance contracts issued or renewed in the state after the act becomes effective.
This bill directs the New Jersey Department of Health to create an all-payer claims database that collects and stores health insurance data from various payers and providers. The database will include information on medical, prescription, dental, and vision claims, along with provider details and enrollment status, while excluding certain plans like Medicare supplements and workers' compensation. Covered entities such as insurance companies, hospitals, pharmacies, and third-party administrators must submit this data, except for self-insured plans governed by federal law. The Department is tasked with securely managing the data, auditing submissions for accuracy, and publishing reports on a public dashboard to improve transparency.
This New Jersey bill ensures that incarcerated individuals do not have to pay for medical care, surgery, dental services, or prescription drugs provided while in state or county custody. It also requires courts to notify health insurance plans when sentencing someone to prison or detention if that person is covered by such a plan. Under the new rules, the state and counties can seek reimbursement from these insurance plans for the costs of medical treatment provided to inmates, rather than charging the inmates themselves. The legislation clarifies that these reimbursement efforts do not interfere with the existing responsibilities of correctional officials to provide care.
This New Jersey bill requires pharmacy benefits managers to provide health plan sponsors with detailed financial reports every six months. The legislation mandates that these reports include specific data on drug costs, rebates, and out-of-pocket spending for each prescription filled through different channels like retail or mail order. By demanding this information in plain language and machine-readable formats, the bill aims to increase transparency regarding how much money is exchanged between drug manufacturers, pharmacies, and insurance plans. Ultimately, the law seeks to help plan sponsors better understand the financial details of their pharmacy benefits contracts.
This New Jersey bill requires all state-regulated health insurance plans to cover pain management services for patients undergoing outpatient gynecological procedures. It mandates that insurers treat these services the same as other medical conditions and prohibits them from labeling such pain management as elective or medically unnecessary. The law applies to a wide range of coverage types, including hospital, medical, and health service corporation contracts as well as individual and group health policies.
This bill requires New Jersey to reimburse volunteer firefighters for periodic cancer screenings that are not covered by their personal health insurance. Starting five years after beginning service, eligible firefighters can receive up to $1,250 every three years for exams covering various cancers, with the amount adjusted annually for inflation. The law ensures there are no out-of-pocket costs, such as deductibles or copayments, and treats volunteer firefighting as an occupational condition for reimbursement purposes. Funding for these payments will come from the state's general fund, and firefighters must provide appropriate records to claim the benefits.
This New Jersey bill mandates that health insurance plans cover early-stage kidney disease screening without requiring patients to pay deductibles, copayments, or coinsurance. It applies to individuals whose doctors determine the screening is medically necessary based on guidelines from the National Kidney Foundation. The law specifically requires coverage for two types of tests: a blood test to measure kidney function and a urine test to check for protein. Insurance companies must treat these screenings the same as other medical conditions, ensuring patients can access them without out-of-pocket costs.
This New Jersey bill requires all health insurance plans, including hospital, medical, and individual policies, to cover sepsis-related treatments if a doctor deems them medically necessary. The law ensures that coverage for sepsis is provided with the same benefits as any other condition and applies to contracts and policies issued or renewed on or after the effective date. By mandating this coverage across various insurance types, the bill aims to guarantee financial support for individuals facing this serious medical condition without discrimination.
This New Jersey bill requires health insurance plans to cover colorectal cancer screenings for all covered individuals aged 33 and older, as well as for those under 33 if a physician deems the screening medically necessary. The law mandates that these screenings follow the most recent guidelines from the United States Preventive Services Task Force and must be provided without any deductibles, copayments, or other cost-sharing fees if a follow-up colonoscopy is needed after a positive initial test. By amending existing statutes for hospital, medical, and health service corporations, the legislation ensures that these specific cancer prevention services are treated with the same coverage standards as other medical conditions.
This New Jersey bill mandates that health insurance plans cover early-stage kidney disease screening without charging patients any deductibles, copayments, or coinsurance. The law specifically requires coverage for blood tests measuring glomerular filtration rate and urine tests checking albumin-creatinine ratios when a physician deems them medically necessary. Insurance providers must treat these screenings with the same benefits as other medical conditions, provided the patient meets clinical guidelines set by the National Kidney Foundation. The policy applies to various types of hospital and medical service contracts issued or renewed in the state after the act takes effect.
