Bill
Bill > S2331
NJ S2331
Requires health insurers, SHBP and SEHBP to provide coverage for diagnosis, evaluation and treatment of lymphedema.
summary
Introduced
03/21/2022
03/21/2022
In Committee
03/21/2022
03/21/2022
Crossed Over
Passed
Dead
01/08/2024
01/08/2024
Introduced Session
2022-2023 Regular Session
Bill Summary
This bill requires health insurers and health maintenance organizations, as well as health benefits plans or contracts which are issued or purchased pursuant to the New Jersey Individual Health Coverage Program, New Jersey Small Employer Health Benefits Program, State Health Benefits Program, and School Employees' Health Benefits Program, to provide coverage for expenses incurred in the diagnosis, evaluation, and treatment of lymphedema that is determined to be medically necessary by the treating physician. Lymphedema is caused by an abnormality of the lymphatic system leading to excessive build-up of tissue fluid that forms lymph, known as interstitial fluid. Interstitial fluid can build up in any area of the body that has inadequate lymph drainage and cause lymphedema. Left untreated, lymphedema leads to chronic inflammation, infection and hardening of the skin that, in turn results in further lymph vessel damage and distortion of the shape of affected body parts. Lymphedema is a condition that develops slowly and once present is usually progressive. Although some people are born with abnormalities in the lymphatic system, a condition known as Primary Lymphedema, most lymphedema in the United States is Secondary Lymphedema. This type of lymphedema occurs from damage to the lymphatic system, commonly from cancer and its treatment, but also from trauma to the skin such as from burns or infections. Lymphedema can occur as a result of breast cancer, melanoma, gynecologic cancer, head and neck cancer, and sarcoma. Early diagnosis of lymphedema is important since treatment is most effective when commenced at the earliest stage of the disease. Lymphedema has no cure, but can be successfully managed when properly diagnosed and treated. Every patient diagnosed with lymphedema should have access to established effective treatment.
AI Summary
This bill requires health insurers, the State Health Benefits Program (SHBP), and the School Employees' Health Benefits Program (SEHBP) to provide coverage for the diagnosis, evaluation, and treatment of lymphedema that is determined to be medically necessary by the patient's physician. Lymphedema is a condition caused by an abnormality in the lymphatic system that leads to the buildup of fluid and tissue, often as a result of cancer treatment. The bill ensures that patients with lymphedema have access to the necessary medical care and treatment, regardless of their insurance provider or health plan. The bill applies to various types of insurance plans, including hospital service corporation contracts, medical service corporation contracts, health service corporation contracts, individual and group health insurance policies, and health maintenance organization contracts. The bill also requires the SHBP and SEHBP to provide this coverage for their enrollees. The bill will take effect on the first day of the seventh month following its enactment.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee (on 03/21/2022)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
---|---|
State Bill Page | https://www.njleg.state.nj.us/bill-search/2022/S2331 |
BillText | https://www.njleg.state.nj.us/Bills/2022/S2500/2331_I1.HTM |
Bill | https://www.njleg.state.nj.us/Bills/2022/S2500/2331_I1.PDF |
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