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Bill > S94


NJ S94

NJ S94
Provides that routine foot care services covered under certain insurance policies include coverage of services provided by podiatric physicians.


summary

Introduced
01/09/2024
In Committee
01/09/2024
Crossed Over
Passed
Dead
01/12/2026

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill would require that a health benefits plan of a hospital, medical or health service corporation, individual, small employer or large group commercial insurer, or health maintenance organization that provides coverage for foot care services would be deemed to include foot care services provided by a podiatric physician. If the health benefits plan excludes coverage for routine foot care services, the term "routine foot care services" would mean the treatment or removal of asymptomatic corns, asymptomatic calluses, or asymptomatic toenails; except that the treatment or removal of asymptomatic corns, asymptomatic calluses, or asymptomatic toenails in the presence of metabolic disease would not be considered routine foot care services. The bill would also require the carrier to make available to a participating health care provider, upon request, a list specifying the types of foot care services, and their related diagnostic and procedure codes, that are excluded under the plan. The bill would additionally require that reimbursement for a covered service be equal for all providers performing the same service, as indicated by the procedure code assigned to the service.

AI Summary

This bill would require that health benefits plans in New Jersey cover foot care services provided by podiatric physicians. If the plan excludes coverage for "routine foot care services," which are defined as the treatment or removal of asymptomatic corns, calluses, or toenails (except where metabolic disease is present), the plan must provide participating providers with a list of the excluded services and their related codes. Additionally, the bill mandates that reimbursement for covered foot care services be equal for all providers performing the same service, as indicated by the procedure code. The provisions of the bill would apply to various types of health plans, including hospital, medical, individual, small employer, and large group plans, as well as health maintenance organizations, for policies issued or renewed on or after the effective date.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 01/09/2024)

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