Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
SYNOPSIS
Mandates health insurance coverage for supervisory billing for behavioral health services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning billing for behavioral health services and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. A carrier, including a carrier that owns, wholly or in part, or contracts with a managed behavioral health care organization, shall allow for the reimbursement for services provided by a mental health professional who is provisionally licensed or otherwise credentialed provisionally and restricted to providing services while under the supervision of an individual licensed in the same mental health profession.
b. A claim for reimbursement shall not be denied solely on the basis that the mental health professional who provided services to a covered individual is provisionally licensed or otherwise credentialed provisionally.
c. For the purposes of this section, “carrier” shall include the State Health Benefits Program, the School Employees’ Health Benefits Program, and the State Medicaid program.
2. This act shall take effect on the first day of the fourth month next following the date of enactment and shall apply to contracts and agreements entered into or renewed on or after the effective date, but the Commissioner of Banking and Insurance may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of the act.
STATEMENT
This bill requires a carrier, including a carrier that owns, wholly or in part, or contracts with a managed behavioral health care organization, to allow for the reimbursement for services provided by a mental health professional who is provisionally licensed or otherwise credentialed provisionally and restricted to providing services while under the supervision of an individual licensed in the same mental health profession. Additionally, a claim for reimbursement is to not be denied solely on the basis that the mental health professional who provided services to a covered individual is provisionally licensed or otherwise credentialed provisionally. For the purposes of the bill, “carrier” shall include the State Health Benefits Program, the School Employees’ Health Benefits Program, and the State Medicaid program.