Bill > S1439

This bill requires various types of health insurance plans in New Jersey to provide expanded coverage for orthotic and prosthetic appliances under two key circumstances: first, for medically necessary appliances prescribed by a physician and obtained from licensed orthotists, prosthetists, podiatrists, or certified pedorthists, and second, for additional appliances that enable patients to engage in physical and recreational activities like running, swimming, skiing, and team sports. The bill applies to hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, individual and small employer health benefits plans, health maintenance organizations, and the State Health Benefits Plan. Under the bill, these health plans must reimburse for orthotic and prosthetic appliances at the same rate as the federal Medicare reimbursement schedule and provide these benefits to the same extent as other medical conditions. The bill defines key terms such as "orthotic appliance" and "prosthetic appliance" by referencing existing state laws, and it will take effect 90 days after enactment, applying to policies and contracts issued or renewed after that date.

Budget and Finance, Business and Industry

https://www.njleg.state.nj.us/bill-search/2024/S1439