Bill Text: NJ A4551 | 2018-2019 | Regular Session | Introduced
Bill Title: Concerns confidentiality of certain communications from health insurance carriers.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2018-10-15 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A4551 Detail]
Download: New_Jersey-2018-A4551-Introduced.html
Sponsored by:
Assemblyman RAJ MUKHERJI
District 33 (Hudson)
Assemblyman JOHN F. MCKEON
District 27 (Essex and Morris)
SYNOPSIS
Concerns confidentiality of certain communications from health insurance carriers.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the confidentiality of certain health insurance communications and supplementing P.L.1997, c.192 (C.26:2S-1 et al.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. (1) As used in this section, "sensitive services" means health care services related to sexual assault, pregnancy, family planning, sexually transmitted diseases, domestic violence and substance or alcohol abuse.
(2) For the purposes of this section, "carrier," as defined in P.L.1997, c.192 (C.26:2S-1 et al.), shall also include the State Health Benefits Program and the School Employees' Health Benefits Program.
b. Any communication from a carrier to a covered person which relates to sensitive services shall be provided using an alternative method of delivery, as designated by the covered person, upon that covered person's written request.
c. A communication is related to sensitive services for the purposes of this section if the communication discloses protected health information, including information regarding treatment or diagnosis, or the name or address of a provider of sensitive services, or if disclosure of all or part of the protected health information could endanger the covered person.
d. Alternative methods for delivery of communications related to sensitive services shall include, but not be limited to, the following:
(1) a paper form sent to the address of the covered person to whom the sensitive service pertains;
(2) a paper form sent to any alternate address designated by the covered person to whom the sensitive service pertains; or
(3) allowing only the covered person to whom the sensitive service pertains to access the communication through electronic means, as available, provided that such access is granted in compliance with any applicable State and federal laws and regulations pertaining to data security.
e. The right to request an alternative method of delivery of communications related to sensitive services, and the process to make such a request, shall be communicated in plain language and in a clear and conspicuous manner in coverage documents and member privacy communications, and shall be conspicuously displayed on the carrier's website and online portals for covered persons.
f. A carrier shall not require an explanation as to the basis for a covered person's request pursuant to this section, unless otherwise required by law or court order.
g. A carrier shall not condition enrollment or coverage on the waiver of rights provided in this section.
2. This act shall take effect on the 120th day next following enactment.
STATEMENT
This bill supplements the "Health Care Quality Act," P.L.1997, c.192 (C.26:2S-1 et al.) by requiring health insurance carriers to honor a request by a covered person for an alternative means of delivery for confidential communications related to sensitive services.
The enactment of the federal "Patient Protection and Affordable Care Act," (ACA) expanded the opportunity for many individuals to maintain health insurance as dependents on a policy held in someone else's name. Under the ACA, children of policyholders may remain on the policy as dependents until they reach the age of 26. In certain cases, coverage for dependents may be extended even further by New Jersey law. As the duration of coverage for dependents increases, so too do concerns for the privacy of these dependents.
Current federal and State laws require carriers to provide policyholders with documentation of the benefits rendered for all persons covered under the policy. As a result, many dependents find themselves having to make a difficult choice between getting the medical treatment they need, and keeping their health information private. This is especially problematic when a dependent has been victimized in some manner by a policyholder, as the dependent may fear for their safety if the policyholder discovers that the dependent sought medical treatment. This bill protects all covered dependents' confidential health information related to sensitive services from being released to policyholders against the wishes of the dependent.
Under this bill, all covered persons are empowered to request that confidential communications from a carrier pertaining to sensitive services be received in a manner of their choosing. "Sensitive services" are defined as health care services related to sexual assault, pregnancy, family planning, sexually transmitted diseases, domestic violence and substance or alcohol abuse. A communication is considered related to sensitive services if the communication discloses protected health information, including information regarding treatment or diagnosis, or the name or address of the provider of sensitive services, or if disclosure of all or part of the protected health information could endanger the covered person.
This bill also protects covered persons by prohibiting a carrier from demanding an explanation for the covered person's request pursuant to this bill, and from conditioning enrollment or coverage on the waiver of rights granted by this bill.
Finally, a carrier is required to communicate the rights established by this bill and the procedure to have these rights recognized in plain language and in a clear and conspicuous manner in coverage documents and member privacy communications, and to conspicuously display this information on the carrier's website and online portals for covered persons.
