Bill
Bill > A2834
NJ A2834
Requires health insurance carriers to provide coverage for persons 18 or younger with diagnosed complex medical needs.
summary
Introduced
01/09/2024
01/09/2024
In Committee
01/09/2024
01/09/2024
Crossed Over
Passed
Dead
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill requires health insurance carriers, including insurance companies, health service corporations, hospital service corporations, medical service corporations, or health maintenance organizations authorized to issue health benefits plans in New Jersey or any entity contracted to administer health benefits in connection with the State Health Benefits Program or School Employees' Health Benefits Program to provide coverage for persons 18 years of age or younger with diagnosed complex medical needs. The bill requires that the benefits be provided for expenses incurred in conducting medical services, procedures, or testing, nursing care, and the purchase of medical equipment or prescription drugs to persons 18 years of age or younger with diagnosed complex medical needs, provided the attending licensed health care provider determines it medically necessary. In addition, the bill requires that health insurance carriers and contracts for health benefits or prescription drug benefits purchased by the State Health Benefits Program and the School Employees' Health Benefits Program approve any benefit for a person 18 years of age or younger with diagnosed complex medical needs within three days of receipt of a letter from the attending licensed health care provider and shall not condition the payment of any benefit for a medical service, procedure, test, nursing care, or purchase of medical equipment or prescription drug upon any pre-approval or precertification of any kind if that medical service, procedure, test, nursing care, or purchase of medical equipment or prescription drug is otherwise covered under the health benefits plan and it has been prescribed by a licensed health care provider.
AI Summary
This bill requires health insurance carriers, including insurance companies, health service corporations, and health maintenance organizations, to provide coverage for persons 18 years of age or younger with diagnosed "complex medical needs." This includes covering expenses for medical services, procedures, testing, nursing care, and the purchase of medical equipment or prescription drugs, as determined medically necessary by the attending licensed health care provider. The bill also mandates that carriers approve any such benefit within three days of receiving a letter from the attending provider and prohibits them from requiring pre-approval or precertification for covered services prescribed by a licensed provider.
Committee Categories
Business and Industry
Sponsors (3)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/09/2024)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
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State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/A2834 |
BillText | https://pub.njleg.gov/Bills/2024/A3000/2834_I1.HTM |
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