Bill Text: NJ S2895 | 2024-2025 | Regular Session | Introduced
Bill Title: Requires health insurance coverage of postpartum pelvic floor physical therapy.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2024-03-04 - Introduced in the Senate, Referred to Senate Commerce Committee [S2895 Detail]
Download: New_Jersey-2024-S2895-Introduced.html
Sponsored by:
Senator LINDA R. GREENSTEIN
District 14 (Mercer and Middlesex)
SYNOPSIS
Requires health insurance coverage of postpartum pelvic floor physical therapy.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health insurance coverage and pelvic floor physical therapy and supplementing various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. 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.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
c. 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. 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.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
c. 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. 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.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
c. 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. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the policy.
c. This section shall apply to those individual health insurance policies in which the insurer has reserved the right to change the premium.
5. a. A group health
insurance policy that provides hospital and medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to
N.J.S.17B:27-26 et seq., or approved for issuance or renewal in this State by
the Commissioner of Banking and Insurance, on or after the effective date of
P.L. ,
c. (C. ) (pending before the Legislature as this bill), shall include
benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the policy.
c. This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium.
6. a. 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.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the plan.
c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
7. a. 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.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the plan.
c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
8. a. 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.), or approved for issuance or renewal in this State by the Commissioner of
Banking and Insurance, on or after the effective date of P.L. ,
c. (C. ) (pending before the Legislature as this bill), shall include
benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
c. This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
9. a. The State Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill) that provides hospital and medical expense benefits shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
10. a. The School Employees' Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill) that provides hospital and medical expense benefits shall include benefits for pelvic floor physical therapy during the postpartum period.
For the purposes of this section, "postpartum period" means one year after childbirth.
b. The benefits shall be provided to the same extent as for any other medical condition under the contract.
11. This act shall take effect on the first day of the seventh month next following enactment and shall apply to all health benefits plans that are 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.
STATEMENT
This bill requires health insurers (health, hospital, and medical service corporations, commercial individual and group health insurers, health maintenance organizations, health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees' Health Benefits Program) to provide coverage for pelvic floor physical therapy during the postpartum period. Under the bill, the "postpartum period" is defined to mean one year after childbirth.
