Bill Text: NJ A684 | 2016-2017 | Regular Session | Introduced
Bill Title: Prohibits payment of more than one copayment, coinsurance or deductible for series of vaccinations used in preventive treatment of rabies under certain health benefits plans.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2016-01-27 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A684 Detail]
Download: New_Jersey-2016-A684-Introduced.html
STATE OF NEW JERSEY
217th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2016 SESSION
Sponsored by:
Assemblywoman NANCY F. MUNOZ
District 21 (Morris, Somerset and Union)
Assemblyman PARKER SPACE
District 24 (Morris, Sussex and Warren)
SYNOPSIS
Prohibits payment of more than one copayment, coinsurance or deductible for series of vaccinations used in preventive treatment of rabies under certain health benefits plans.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning the preventive treatment of rabies under certain health benefits plans 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. Notwithstanding the provisions of the "Health Care Quality Act," P.L.1997, c.192 (C.26:2S-1 et seq.), or any other law to the contrary, with respect to a health care provider treating a covered person under a health benefits plan for rabies, which treatment includes a series of vaccinations administered in a hospital emergency room or similar setting to prevent the onset and symptoms of rabies:
(1) The covered person shall be responsible for the payment of only one copayment, coinsurance or deductible to the health care provider for that series of vaccinations during any period of 180 days following the payment of that copayment, coinsurance or deductible, regardless of the number of follow-up care visits for that series of vaccinations during that period;
(2) The health care provider shall not collect more than one copayment, coinsurance or deductible during any period of 180 days following the payment of that copayment, coinsurance or deductible, regardless of the number of follow-up care visits for that series of vaccinations during that period; and
(3) The health benefits plan shall not require the payment of more than one copayment, coinsurance or deductible by the covered person during any period of 180 days following the payment of that copayment, coinsurance or deductible, regardless of the number of follow-up care visits for that series of vaccinations during that period.
b. As used in this section, "health benefits plan" means a health benefits plan which pays or provides hospital or medical expense benefits for covered services and is delivered or issued for delivery by or through a carrier, and any contract for hospital or medical expense benefits purchased by the State Health Benefits Commission or the School Employees' Health Benefits Commission, on or after the effective date of this act.
2. This act shall take effect immediately.
STATEMENT
This bill prohibits payment of more than one copayment, coinsurance or deductible for the series of vaccinations used in preventive rabies treatment.
The current standard protocol for this treatment dictates that the administration of this series of vaccinations shall only take place in an emergency room or similar hospital setting because the vaccine is only readily accessible in that setting. Thus, the typically higher emergency room or hospital copayment, coinsurance or deductible under any applicable health benefits plan may be charged each time the person suspected of contracting rabies returns to the hospital to receive another in the series of vaccinations. By permitting only one payment for this series of vaccinations in this way, the often prohibitive cost of an emergency room copayment, coinsurance or deductible is removed as an obstacle to receiving the treatment.
The bill provides that the covered person receiving the treatment shall be responsible for the payment of only one copayment, coinsurance or deductible for that series of vaccinations during any period of 180 days following that payment, regardless of the number of follow-up care visits for that series of vaccinations during that period. Similarly, the health care provider shall not collect more than one copayment, coinsurance or deductible during any such period of 180 days and the health benefits plan shall not require payment of more than one copayment, coinsurance or deductible by the covered person during that period.
The bill supplements the "Health Care Quality Act," P.L.1997, c.192 (C.26:2S-1 et seq.) and would apply to health benefits plans issued by health insurance carriers, as defined by that act, the State Employees Health Benefits Program, and the School Employees' Health Benefits Program.
