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Bill > A4272


NJ A4272

NJ A4272
Requires health benefits coverage for private duty nursing services.


summary

Introduced
06/27/2018
In Committee
06/27/2018
Crossed Over
Passed
Dead
01/08/2020

Introduced Session

2018-2019 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 to provide coverage for private duty nursing services. Private duty nursing services are defined as nursing care provided by a registered nurse or licensed practical nurse, under the direction of a physician, to a recipient in their own home, a hospital, or a skilled nursing facility. The coverage is subject to the same deductibles, coinsurance, and other cost-sharing as similar services under the insurance contract, policy, or plan. Insurers are allowed to require prior authorization for these services.

Committee Categories

Business and Industry

Sponsors (5)

Last Action

Assembly Financial Institutions and Insurance Hearing (19:00 5/13/2019 A5323 - Freiman (pending intro & referral) - Requires consumer l) (on 05/13/2019)

bill text


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