Sponsored by:
Senator TROY SINGLETON
District 7 (Burlington)
SYNOPSIS
Requires SHBP and SEHBP to establish audit program ensuring that all persons in SHBP and SEHBP eligible for Medicare have Medicare as primary provider of health benefits coverage.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning an audit program for the SHBP and the SEHBP, amending P.L.2008, c.89 and supplementing P.L.2007, c.103 (C.52:14-17.46.1 et seq)
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 17 of P.L.2008, c.89 (C.52:14-17.26a) is amended to read as follows:
17. a. The State Health Benefits Commission shall establish an audit program through which it shall conduct a continuous review of the various public employers participating in the State Health Benefits Program for the purpose of ensuring that only eligible employees and retirees, and their dependents, are receiving health care coverage under the program. Every public entity whose employees are covered by the program, as well as employees and retirees thereof, and their dependents, and any other public entity having relevant information, shall cooperate fully with the commission and shall provide all information, records and documents requested by the commission in connection with an audit.
b. The State Health Benefits Commission shall establish an audit program through which it shall conduct a continuous review of the State Health Benefits Program for the purposes of ensuring that all persons who are participants and their dependents of the State Health Benefits Program and who are eligible for Medicare under federal law, are properly enrolled in Medicare at the time of initial eligibility with Medicare as the primary provider of their health care benefits coverage and with the State Health Benefits Program as their secondary provider of their health care benefits coverage.
(cf: P.L.2008, c.89, s.17)
2. (New section) The
School Employees’ Health Benefits Commission shall establish an audit program
through which it shall conduct a continuous review of the School Employees’
Health Benefits Program for the purposes of ensuring that all persons who are
participants and their dependents of the School Employees’ Health Benefits
Program and who are eligible for Medicare under federal law, are properly
enrolled in Medicare at the time of initial eligibility with Medicare as the
primary provider of their health care benefits coverage and with the School
Employees’ Health Benefits Program as their secondary provider of their health
care benefits coverage.
3. This act shall take effect immediately.
STATEMENT
This bill requires the State Health Benefits Commission and the School Employees’ Health Benefits Commission to establish an audit program that will continuously review the status of all persons who are participants and their dependents of either the State Health Benefits program or the School Employees’ Health Benefits Program and who are eligible for Medicare under federal law, are properly enrolled in Medicare at the time of initial eligibility in Medicare with Medicare as their primary health benefits coverage provider and the with State Health Benefits Program or the School Employees’ Health Benefits Program as their secondary health benefits coverage provider.