Bill Text: NJ A2191 | 2010-2011 | Regular Session | Introduced
Bill Title: Requires health benefits coverage for bone mass measurement.
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2010-02-11 - Introduced, Referred to Assembly Health and Senior Services Committee [A2191 Detail]
Download: New_Jersey-2010-A2191-Introduced.html
Sponsored by:
Assemblywoman NANCY F. MUNOZ
District 21 (Essex, Morris, Somerset and Union)
SYNOPSIS
Requires health benefits coverage for bone mass measurement.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health benefits coverage for bone mass measurement and supplementing various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. No group or individual hospital service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), 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 a subscriber or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
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. No group or individual medical service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.), 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 a subscriber or other person covered thereunder for expenses incurred for bone mass measurement. For purposes of this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
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. No group or individual health service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.), 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 a subscriber or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
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. No individual health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, 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 an insured or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to all health insurance policies in which the health insurer has reserved the right to change the premium.
5. No group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State pursuant to chapter 27 of Title 17B of the New Jersey Statutes, 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 an insured or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to all health insurance policies in which the health insurer has reserved the right to change the premium.
6. No individual health benefits plan subject to the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) 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 an insured or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to all health insurance policies in which the health insurer has reserved the right to change the premium.
7. No small employer health benefits plan subject to the provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) 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 an insured or other person covered thereunder for expenses incurred for bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to all health insurance policies in which the health insurer has reserved the right to change the premium.
8. No certificate of authority to establish and operate a health maintenance organization in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) shall 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 bone mass measurement. As used in this section, "bone mass measurement" means a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure.
The Commissioner of Health and Senior Services shall, in consultation with the Commissioner of Banking and Insurance, establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits under this section.
The health care services shall be provided to the same extent as for any other medical condition under the enrollee agreement.
This section shall apply to all enrollee agreements under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
9. An employer who provides a comprehensive self-funded health benefits plan to his employees or their dependents in this State that does not provide coverage for bone mass measurement as otherwise required pursuant to this act, shall annually notify his employees that they are covered by a self-funded health benefits plan that is not subject to regulation by the State of New Jersey, and specify that the health benefits coverage for bone mass measurement, otherwise required pursuant to this act, is not covered by the self-funded health benefits plan.
10. This act shall take effect on the 90th day following enactment and shall apply to contracts and policies issued or renewed on or after that date.
STATEMENT
This bill requires health insurers, including hospital service corporations, medical service corporations, health service corporations, commercial insurers, health maintenance organizations, and health benefits plans issued pursuant to the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program, to provide benefits for expenses incurred for bone mass measurement. Bone mass measurement is a non-invasive method used to diagnose osteoporosis before fractures occur.
The bill defines "bone mass measurement" as a radiologic or radioisotopic procedure or other procedure, approved by the federal Food and Drug Administration, and performed on a person for the purpose of identifying bone mass, detecting bone loss or determining bone quality, and includes a physician's interpretation of the results of the procedure. The bill also provides that the Commissioner of Health and Senior Services, together with the Commissioner of Banking and Insurance, shall establish standards regarding the frequency with which a person shall be eligible for bone mass measurement benefits.
In addition, the bill provides that employers who provide comprehensive self-funded health benefits plans to employees or their dependents that do not cover bone mass measurement benefits shall notify their employees that they are covered by a self-funded plan that is not subject to regulation by the State of New Jersey, and to specify that the health benefits coverage for bone mass measurement required pursuant to the bill is not covered under the self-funded plan.
