This bill amends New Jersey law to mandate health benefits coverage for an additional orthotic or prosthetic appliance when deemed medically necessary by a physician. This requirement specifically targets appliances that support individuals in engaging in physical and recreational activities, such as running, swimming, and skiing. The bill ensures that health insurance contracts cover expenses for both a primary and an additional orthotic or prosthetic appliance, which was not previously required.

Additionally, the bill stipulates that reimbursement for these appliances must align with the federal Medicare reimbursement schedule, facilitating access to necessary devices for individuals with health insurance. The provisions will take effect 90 days after enactment and will apply to policies or contracts issued or renewed thereafter. The bill encompasses a broad range of health coverage providers, including hospital and medical corporations, commercial insurers, health maintenance organizations, and state health programs, thereby promoting a more active lifestyle for individuals who require these supportive devices.

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