Bill Text: NJ S64 | 2016-2017 | Regular Session | Introduced
Bill Title: Requires health insurers to provide coverage for positron emission tomography to diagnose Alzheimer's disease.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2016-01-12 - Introduced in the Senate, Referred to Senate Commerce Committee [S64 Detail]
Download: New_Jersey-2016-S64-Introduced.html
Sponsored by:
Senator ANTHONY R. BUCCO
District 25 (Morris and Somerset)
SYNOPSIS
Requires health insurers to provide coverage for positron emission tomography to diagnose Alzheimer's disease.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning health insurance coverage for positron emission tomography to diagnose Alzheimer's disease and supplementing Titles 17 and 26 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 or medical expense benefits and is 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, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions 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 or medical expense benefits and is 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, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions 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 or medical expense benefits and is 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, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions 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. A group health insurance policy that provides hospital or medical expense benefits and is 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, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions under the policy.
This section shall apply to those insurance policies in which the insurer has reserved the right to change the premium.
5. An individual health insurance policy that provides hospital or medical expense benefits and is 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, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions under the policy.
This section shall apply to those insurance policies in which the insurer has reserved the right to change the premium.
6. A certificate of authority to establish and operate a health maintenance organization in this State shall not 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 coverage for the use of positron emission tomography to diagnose Alzheimer's disease.
The health care services shall be provided to the same extent as for any other medical conditions under the contract for health care services.
The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
7. An individual health benefits plan that provides hospital or 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.) or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions 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 small employer health benefits plan that provides hospital or 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.) or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide coverage for medically necessary expenses incurred in the use of positron emission tomography to diagnose Alzheimer's disease.
The benefits shall be provided to the same extent as for any other medical conditions 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.
9. This act shall take effect on the 30th day after enactment.
STATEMENT
This bill would require hospital, medical, and health service corporations, individual, small employer, and larger employer commercial insurers, and health maintenance organizations to provide coverage for medically necessary expenses incurred in the use of positron emission tomography (PET scan) to diagnose Alzheimer's disease.
PET scans are among the most sensitive tests available for early detection of Alzheimer's disease, and use of the PET scan will enable treatment for Alzheimer's disease to begin as soon as possible, before the disease is in an advanced stage.
