Bill Text: NJ A3246 | 2010-2011 | Regular Session | Introduced
Bill Title: Requires managed care plans, SHBP, and SEHBP to provide for reasonable accommodation in accessing providers for persons with physical disabilities. *
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced - Dead) 2011-12-08 - Reported out of Assembly Comm. with Amendments, 2nd Reading [A3246 Detail]
Download: New_Jersey-2010-A3246-Introduced.html
Sponsored by:
Assemblywoman JOAN M. QUIGLEY
District 32 (Bergen and Hudson)
Assemblyman CRAIG J. COUGHLIN
District 19 (Middlesex)
SYNOPSIS
Requires managed care plans, SHBP, and SEHBP to provide for reasonable accommodation in accessing providers for persons with disabilities.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health care coverage for persons with physical disabilities and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.), P.L.1961, c.49 (C.52:14-17.25 et seq.), and 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. A carrier which offers a managed care plan that is subject to the provisions of P.L.1997, c.192 (C.26:2S-1 et seq.) shall establish procedures to ensure that persons with disabilities have reasonable access to primary and specialty care providers whose professional offices are accessible to persons with disabilities in accordance with the Americans with Disabilities Act of 1990 standards for accessible design published by the United States Department of Justice pursuant to 28 CFR Part 36.
The procedures shall provide that in the event a covered person with a disability is unable to reasonably access an in-network primary or specialty care provider whose professional office is accessible to the covered person, the carrier shall arrange for a provider that is accessible, with the same financial responsibility as the covered person would incur if the provider was in-network.
2. 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 or medical expense benefits through a managed care plan, provides procedures to ensure that persons with disabilities have reasonable access to primary and specialty care providers whose professional offices are accessible to persons with disabilities in accordance with the Americans with Disabilities Act of 1990 standards for accessible design published by the United States Department of Justice pursuant to 28 CFR Part 36.
The procedures shall provide that in the event a covered person with a disability is unable to reasonably access an in-network primary or specialty care provider whose professional office is accessible to the covered person, the managed care plan shall arrange for a provider that is accessible, with the same financial responsibility as the covered person would incur if the provider was in-network.
3. 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 or medical expense benefits through a managed care plan, provides procedures to ensure that persons with disabilities have reasonable access to primary and specialty care providers whose professional offices are accessible to persons with disabilities in accordance with the Americans with Disabilities Act of 1990 standards for accessible design published by the United States Department of Justice pursuant to 28 CFR Part 36.
The procedures shall provide that in the event a covered person with a disability is unable to reasonably access an in-network primary or specialty care provider whose professional office is accessible to the covered person, the managed care plan shall arrange for a provider that is accessible, with the same financial responsibility as the covered person would incur if the provider was in-network.
4. This act shall take effect on the 90th day following enactment and shall apply to any contract or policy issued or renewed on or after that date.
STATEMENT
This bill ensures that persons with disabilities, who have health insurance through a managed care plan, have reasonable access to primary care and specialist providers whose professional offices are accessible in accordance with the federal Americans with Disability Act of 1990 (ADA) standards for accessible design. The provisions of the bill apply to individual, small employer and larger employer health benefits plans, and plans issued by the State Health Benefits Program and the School Employees' Health Benefits Program.
Specifically, the bill requires a carrier which offers a managed care plan to establish procedures to ensure that persons with disabilities have reasonable access to primary and specialty care providers whose professional offices are accessible to persons with disabilities in accordance with the ADA standards for accessible design published by the United States Department of Justice pursuant to 28 CFR Part 36.
Under the bill, the procedures must provide that if a covered person with a disability is unable to reasonably access an in-network primary or specialty care provider whose professional office is accessible to the covered person, the carrier shall arrange for a provider that is accessible, with the same financial responsibility as the covered person would incur if the provider was in-network.
The bill similarly applies these requirements to managed care plan contracts purchased by the State Health Benefits Commission and the School Employees' Health Benefits Commission.
The bill takes effect on the 90th day after enactment and applies to any health insurance contract or policy issued or renewed on or after that date.
