Sponsored by:
Senator JOSEPH A. LAGANA
District 38 (Bergen and Passaic)
Senator VIN GOPAL
District 11 (Monmouth)
SYNOPSIS
Requires insurance coverage for testing and treatment of coronavirus disease 2019.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health insurance coverage and coronavirus disease 2019 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 that offers a health benefits plan in this State shall provide coverage for medical expenses incurred in the testing and treatment of coronavirus disease 2019, provided that a health care provider has issued a medical order for the testing or treatment. No cost-sharing shall be imposed on the coverage provided pursuant to this section. The coverage provided pursuant to this section shall not be subject to review of medical necessity or any other utilization management review.
b. As used in this section, “carrier,” means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, and shall include the State Health Benefits Program and the School Employees' Health Benefits Program.
2. This act shall take effect immediately and shall apply to all health benefits plans currently in effect in the State, or that are 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.
STATEMENT
This bill requires health insurance carriers (health, hospital and medical service corporations, health maintenance organizations and insurance companies), as well as the State and School Employees’ Health Benefits Programs, to provide coverage for medical treatment incurred in the testing and treatment of coronavirus disease 2019 (COVID-19), provided that a health care provider has issued a medical order for the testing or treatment. The coverage must be provided to the covered person without cost-sharing and is not subject to review of medical necessity or any other utilization management review.
The bill takes effect immediately and applies to all health benefit plans currently in effect in the State, or that are 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 the bill.
COVID-19 is a respiratory disease caused by a novel coronavirus that was first detected in China and which has now been detected in many locations around the world, including in the United States. Reported illnesses have ranged from mild to severe, including illness resulting in death. According to the Centers for Disease Control and Prevention, it is likely that at some point, widespread transmission of COVID-19 in the United States will occur.