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Bill > A5133


NJ A5133

NJ A5133
Requires health insurance and Medicaid coverage for the treatment of stuttering.


summary

Introduced
12/16/2024
In Committee
04/10/2025
Crossed Over
Passed
Dead

Introduced Session

2024-2025 Regular Session

Bill Summary

Requires health insurance and Medicaid coverage for the treatment of stuttering.

AI Summary

This bill requires various health insurance providers in New Jersey, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, health maintenance organizations, and state health benefit plans, to provide coverage for stuttering treatment. Specifically, the bill mandates that these insurance providers cover habilitative and rehabilitative speech therapy for stuttering when deemed medically necessary by a medical doctor. These services can be delivered in-person, through telemedicine, or telehealth. The bill removes previous language that would have prohibited any prior authorization or utilization management requirements and would have eliminated all cost-sharing for these services. Instead, the coverage will be provided to the same extent as other medical services, meaning standard copayments, deductibles, and other cost-sharing mechanisms may still apply. The bill also extends these coverage requirements to the Medicaid program, ensuring that individuals served under Medicaid can receive similar benefits for stuttering treatment. The new requirements will take effect 90 days after enactment and will apply to all policies, plans, and contracts delivered, executed, issued, or renewed after that date. The bill defines habilitative speech therapy as therapy that helps a person keep, learn, or improve skills for daily living, and rehabilitative speech therapy as therapy that helps a person restore or improve skills that have been lost or impaired.

Committee Categories

Business and Industry, Health and Social Services

Sponsors (18)

Last Action

Reported out of Asm. Comm. with Amendments, and Referred to Assembly Health Committee (on 04/10/2025)

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