Bill Text: NJ S413 | 2016-2017 | Regular Session | Introduced
Bill Title: Requires insurers and State health care coverage programs to cover cost of HIV vaccine.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2016-01-12 - Introduced in the Senate, Referred to Senate Commerce Committee [S413 Detail]
Download: New_Jersey-2016-S413-Introduced.html
STATE OF NEW JERSEY
217th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2016 SESSION
Sponsored by:
Senator SAMUEL D. THOMPSON
District 12 (Burlington, Middlesex, Monmouth and Ocean)
SYNOPSIS
Requires insurers and State health care coverage programs to cover cost of HIV vaccine.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning insurance coverage for an HIV vaccine and supplementing Titles 17, 26, 30, and 52 of the Revised Statutes and Title 17B of the New Jersey Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. A hospital service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a hospital service corporation to provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
2. A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.), on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a medical service corporation to provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
3. A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.), on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a health service corporation to provide benefits for any clinical trial relating to an AIDS vaccine or for any AIDS vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.
4. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require an insurer to provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
5. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 27 of Title 17B of the New Jersey Statutes, on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require an insurer to provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
6. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a health benefits plan to provide benefits for any clinical trials relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
7. A small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), on or after the effective date of this act, shall provide benefits for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a health benefits plan to provide benefits for any clinical trials relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
8. A health maintenance organization contract for health care services that is delivered, issued, executed or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), on or after the effective date of this act, shall provide health care services for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require a health maintenance organization to provide health care services for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The health care services shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those contracts for health care services under which the right to change the schedule of charges for enrollee coverage is reserved.
9. 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 shall provide coverage for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require the State Health Benefits Program to provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
The benefits shall be provided to the same extent as for any other medical condition under the program.
10. The Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et seq.) shall provide coverage for expenses incurred for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
This section shall not be construed to require the Medicaid program or the NJ FamilyCare Program to provide coverage for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
11. This act shall take effect on the 90th day after enactment, and shall apply to policies or contracts issued or renewed on or after the effective date.
STATEMENT
This bill requires that health insurers (hospital, medical and health service corporations, commercial individual, small employer and larger group insurers, and health maintenance organizations), the State Health Benefits Program, and the State Medicaid and NJ FamilyCare programs provide coverage for a vaccination against the human immunodeficiency virus (HIV) that is approved for marketing by the federal Food and Drug Administration and is recommended by the United States Public Health Service.
The bill does not require that any insurer or State program provide benefits for any clinical trial relating to an HIV vaccine or for any HIV vaccine that has been approved by the federal Food and Drug Administration in the form of an investigational new drug application.
HIV is the virus that causes acquired immune deficiency syndrome (AIDS). The purpose of this bill is to help create, along with similar legislation in other states, a sufficient incentive to expedite development of an effective HIV vaccine by guaranteeing a market for it. Medical advances in the treatment of HIV and AIDS have led to a dramatic reduction in the number of new AIDS cases and AIDS-related deaths in the United States; however, treatment of HIV/AIDS is extremely costly, and more than 90% of new HIV infections outside this country occur in developing countries where the cost of antiretroviral therapy limits its availability to a select few. The only solution to the worldwide AIDS epidemic is an HIV vaccine.
