Sponsored by:
Assemblyman DANIEL R. BENSON
District 14 (Mercer and Middlesex)
SYNOPSIS
Requires health insurers to provide coverage for equine therapy or rehabilitation under certain circumstances.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health insurance coverage for equine therapy or 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. A group or individual hospital service corporation contract providing hospital or medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the contract.
c. This section shall apply to all hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
2. a. A group or individual medical service corporation contract providing hospital or medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the contract.
c. This section shall apply to all medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
3. a. A group or individual health service corporation contract providing hospital or medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the contract.
c. This section shall apply to all health service corporation contracts in which the health service corporation has reserved the right to change the premium.
4. a. An individual health insurance policy providing hospital or medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the policy.
c. This section shall apply to all individual health insurance policies in which the insurer has reserved the right to change the premium.
5. a. A group health insurance policy that provides hospital and medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the policy.
c. This section shall apply to all group health insurance policies in which the insurer has reserved the right to change the premium.
6. a. An individual health benefits plan that provides hospital and medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the plan.
c. This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium.
7. a. A small employer health benefits plan that provides hospital and medical expense benefits 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, shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These benefits shall be provided to the same extent as for any other treatment of a medical condition under the plan.
c. This section shall apply to all small employer health benefit plans in which the carrier has reserved the right to change the premium.
8. a. A certificate of authority to operate a health maintenance organization in this State issued or continued by the Commissioner of Banking and Insurance on or after the effective date of this act shall include health care services for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These services shall be provided by the health maintenance organization to the same extent as for any other treatment of a medical condition under the contract.
c. This section shall apply to all contracts for health care services by health maintenance organizations in which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
9. a. The State Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital and medical expense benefits shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These services shall be provided to the same extent as for any other treatment of a medical condition under the contract.
10. a. The School Employees’ Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital and medical expense benefits shall include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.
b. These services shall be provided to the same extent as for any other treatment of a medical condition under the contract.
11. This act shall take effect on the 180th day next following enactment.
STATEMENT
This bill requires health insurers and health maintenance organizations, as well as health benefits plans or contracts which are issued or purchased pursuant to the New Jersey Individual Health Coverage Program, New Jersey Small Employer Health Benefits Program, State Health Benefits Program, and School Employees’ Health Benefits Program, to include benefits for treatment by means of equine therapy or rehabilitation for a covered disease or condition if that treatment or rehabilitation is prescribed as medically necessary by a health care provider.
For the purposes of this section, “equine therapy or rehabilitation” means the discipline of using horses as a means to provide metaphoric experiences in order to promote emotional growth through horse care, grooming procedures, saddlery, and basic equitation.