The bill amends New Jersey law to mandate that various health insurance entities, including hospital service corporations and health maintenance organizations, provide coverage for orthotic and prosthetic appliances. It requires that these expenses be covered when deemed medically necessary by a physician and allows for an additional appliance if necessary for physical and recreational activities. Furthermore, the bill stipulates that reimbursement for these appliances must align with the federal Medicare reimbursement schedule, ensuring that benefits for orthotic and prosthetic devices are equivalent to those for any other medical condition.

Additionally, the bill modifies section 18 of P.L.1991, c.512 (C.45:12B-18) to ensure that contracts purchased by the commission will reimburse for orthotic and prosthetic appliances at the same rate as the federal Medicare reimbursement schedule. The benefits for these appliances will be provided to the same extent as benefits for any other medical condition under the contract. The act is set to take effect 90 days after enactment and will apply to policies or contracts issued or renewed on or after that date.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.30, 17B:26-2.1, 17B:27-46.1, 17B:27A-7.13, 17B:27A-19.17, 26:2J-4.31, 52:14-17.29
Advance Law: 17:48-6, 17:48A-7, 17:48E-35.30, 17B:26-2.1, 17B:27-46.1, 17B:27A-7.13, 17B:27A-19.17, 26:2J-4.31, 52:14-17.29
Pamphlet Law: 17:48-6, 17:48A-7, 17:48E-35.30, 17B:26-2.1, 17B:27-46.1, 17B:27A-7.13, 17B:27A-19.17, 26:2J-4.31, 52:14-17.29