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Bill > A2227


NJ A2227

NJ A2227
Requires health benefits coverage for private duty nursing services.


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 requires health insurers (health, hospital and medical service corporations, commercial individual and group health insurers, health maintenance organizations, health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees' Health Benefits Program) to provide health benefits coverage for any expenses incurred in the provision of private duty nursing services. Under the bill, private duty nursing services are subject to the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract, policy, or plan. Nothing in the bill is intended to prevent a contract, policy, or plan from requiring prior authorization for services. As used in the bill, "private duty nursing services" means nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of the hospital or skilled nursing facility. These services are provided: (1) by a registered nurse or a licensed practical nurse; (2) under the direction of the recipient's physician; and (3) to a recipient in that person's own home, a hospital, or a skilled nursing facility.

AI Summary

This bill requires health insurers in New Jersey, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurers, health maintenance organizations, and state and school employee health benefits programs, to provide coverage for private duty nursing services. Private duty nursing services are defined as nursing services provided by a registered nurse or licensed practical nurse under the direction of a physician to a recipient in their home, a hospital, or a skilled nursing facility who requires more individual and continuous care than is available from a visiting nurse or routinely provided by the hospital or nursing facility staff. The bill specifies that the coverage for private duty nursing services must be subject to the same deductibles, coinsurance, and other cost-sharing as apply to similar services under the contract, policy, or plan, and that prior authorization may be required. The bill takes effect on January 1 of the year following its enactment.

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/09/2024)

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