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Bill > A3440


NJ A3440

NJ A3440
Requires health benefits coverage for private duty nursing services.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 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 mandates that various health insurance providers, including hospital and medical service corporations, individual and group health insurers, health maintenance organizations (HMOs), and state-administered health plans like the State Health Benefits Program and the School Employees' Health Benefits Program, must cover expenses for private duty nursing services. Private duty nursing services are defined as continuous, individualized nursing care provided by a registered nurse (RN) or licensed practical nurse (LPN) under a physician's direction, either in a patient's home, a hospital, or a skilled nursing facility, for individuals needing more intensive care than typically offered by visiting nurses or regular hospital/facility staff. These services will be subject to the same deductibles, coinsurance, and other cost-sharing requirements as other similar services covered by the plan, and insurers can still require prior authorization for these services.

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/13/2026)

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