This bill mandates that various health insurance providers in New Jersey, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, health maintenance organizations, and health benefits plans, must cover expenses related to the treatment of Lyme disease. Coverage is required for treatments deemed medically necessary by a physician after a thorough evaluation of the patient's symptoms and condition. Additionally, the bill stipulates that treatment cannot be denied solely on the grounds that it is considered experimental or investigational.
The legislation applies to contracts and policies delivered, issued, executed, or renewed in New Jersey on or after the effective date of the act, which is set for 90 days post-enactment. It ensures that all relevant health insurance plans, including those under the State Health Benefits Program and the School Employees Health Benefits Program, adhere to these coverage requirements, thereby enhancing access to necessary medical care for individuals affected by Lyme disease.