This bill mandates that health insurance providers and the State Medicaid program in New Jersey cover medical expenses related to the screening, prevention, and treatment of behavioral health issues in children. It requires that claims for these services be accepted and reimbursed when using an "at-risk diagnosis," which is defined as a diagnosis that considers various factors affecting a child's behavioral health and development without leading to a formal mental health diagnosis. This provision aims to promote preventive care and allows providers to use alternative billing codes, including Social Determinants of Health Z-codes, for children aged 18 and younger.

The bill applies to a wide range of health insurers, including those offering health benefits plans under the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, as well as the State Health Benefits Program and the School Employees Health Benefits Program. It also outlines the responsibilities of the State Health Benefits Commission and the Division of Medical Assistance and Health Services to ensure compliance with these requirements. The act will take effect 90 days after enactment and will apply to all relevant policies, plans, and contracts issued or renewed thereafter.