Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex)
SYNOPSIS
Requires health insurance coverage of at-home rehabilitation services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning at-home rehabilitation and supplementing various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. No group or individual hospital service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for expenses incurred in conducting at-home rehabilitation services.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the hospital service corporation has reserved the right to change the premium.
d. As used in this section, at-home rehabilitation means the treatment of an individual suffering from a functional physical or mental impairment due to injury or disease through use of medical equipment or other means and within the individual s home.
2. a. No group or individual medical service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for expenses incurred in conducting at-home rehabilitation services.
b. These benefits shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the medical services corporation has reserved the right to change the premium.
d. As used in this section, at-home rehabilitation means the treatment of an individual suffering from a functional physical or mental impairment due to injury or disease through use of medical equipment or other means and within the individual s home.
3. a. No group or individual health service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for expenses incurred in conducting at-home rehabilitation services.
b. These benefits shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the health services corporation has reserved the right to change the premium.
d. As used in this section, at-home rehabilitation means the treatment of an individual suffering from a functional physical or mental impairment due to injury or disease through use of medical equipment or other means and within the individual s home.
4. a. No individual health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the policy provides benefits to any named insured or other person covered thereunder for expenses incurred in conducting at-home rehabilitation services.
b. These benefits shall be provided to the same extent as for any other medical condition under the policy.
c. The provision of this section shall apply to all policies in which the insurer has reserved the right to change the premium.
d. As used in this section, at-home rehabilitation means the treatment of an individual suffering from a functional physical or mental impairment due to injury or disease through use of medical equipment or other means and within the individual s home.
5. a. No group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the policy provides benefits to any named insured or other person covered thereunder for expenses incurred in conducting at-home rehabilitation services.
b. These benefits shall be provided to the same extent as for any other medical condition under the policy.
c. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium.
d. As used in this section, at-home rehabilitation means the treatment of an individual suffering from a functional physical or mental impairment due to injury or disease through use of medical equipment or other means and within the individual s home.
6. a. Notwithstanding any provision of law to the contrary, a certificate of authority to establish and operate a health maintenance organization in this State shall not be issued or continued by the Commissioner of Banking and Insurance on or after the effective date of this act unless the health maintenance organization provides health care services to any enrollee for the use of at-home rehabilitation services.
b. These health care services shall be provided to the same extent as for any other medical condition under the enrollee agreement.
c. The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
d. As used in this section, at-home rehabilitation means the tre