Bill Text: NJ S575 | 2018-2019 | Regular Session | Introduced


Bill Title: Requires hospital employees assist uninsured patients with creating account to apply for insurance coverage through Federally-Facilitated Marketplace.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2018-01-09 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S575 Detail]

Download: New_Jersey-2018-S575-Introduced.html

SENATE, No. 575

STATE OF NEW JERSEY

218th LEGISLATURE

 

PRE-FILED FOR INTRODUCTION IN THE 2018 SESSION

 


 

Sponsored by:

Senator  NICHOLAS J. SACCO

District 32 (Bergen and Hudson)

Senator  LORETTA WEINBERG

District 37 (Bergen)

 

 

 

 

SYNOPSIS

     Requires hospital employees assist uninsured patients with creating account to apply for insurance coverage through Federally-Facilitated Marketplace.

 

CURRENT VERSION OF TEXT

     Introduced Pending Technical Review by Legislative Counsel.

  


An Act concerning uninsured patients and supplementing Title 26 of the Revised Statutes.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    a.  As used in this section:

     "Designated hospital employee" means an employee of the hospital who has received training in the collection of patient financial data and identification of third party coverage, and who may additionally be registered or otherwise permitted to assist patients in accessing and navigating the Federally-Facilitated Marketplace, in accordance with applicable State and federal law.

     "Federally-Facilitated Marketplace" means the health insurance marketplace established pursuant to the federal "Patient Protection and Affordable Care Act," Pub.L.111-148, as amended by the federal "Health Care and Education Reconciliation Act of 2010," Pub.L.111-152.

     b.    Prior to a patient's discharge from a hospital, a designated hospital employee shall interview the patient to determine the patient's health insurance status.  If the nature of the patient's required health care makes the patient interview impractical, the designated hospital employee shall interview a family member or guardian of the patient.  The designated hospital employee shall inquire of the patient, family member, or guardian whether the patient is covered by health insurance and, if so, shall request documentation of the evidence of health insurance coverage.  Documentation may include, but shall not be limited to, a government sponsored health plan card or number, a group sponsored or direct subscription health plan card or number, a commercial insurance identification card or claim form, or a union welfare plan identification card or claim form. 

     c.     If it is determined upon the discharge interview that the patient does not have health insurance, the designated hospital employee shall assist the patient to create an account enabling the patient to access the Federally-Facilitated Marketplace website and shall additionally provide the following assistance:

     (1)   If the patient's request for care occurs during the open enrollment period for purchasing health insurance through the Federally-Facilitated Marketplace, the employee may, to the extent permitted by law, assist the patient with registering an account with the Federally-Facilitated Marketplace website.  If the employee is registered as a Navigator, Certified Application Counselor, or is otherwise permitted by State and federal law to assist individuals in enrolling in a health insurance plan, the employee shall offer assistance to the patient in applying for potential subsidies and enrolling in a qualified health plan of the patient's choice.  An employee not designated to provide assistance in enrollment may refer the patient to an appropriate staff member or entity to continue the enrollment process.

     (2)   If the patient's request for care does not occur during the open enrollment period for purchasing health insurance through the Federally-Facilitated Marketplace, if the designated employee is not registered or permitted by law or is otherwise unable to provide the assistance described in paragraph (1) of this subsection, if the patient chooses not to purchase insurance through the Federally-Facilitated Marketplace, or if the patient does not obtain insurance through the Federally-Facilitated Marketplace for any other reason, the designated employee shall provide the patient, family member, or guardian with information about resources available to assist the patient in navigating the Federally-Facilitated Marketplace website, purchasing health insurance through the Federally-Facilitated Marketplace, and the dates of the next open enrollment period.

     (3)   If it is determined during the patient's discharge interview that the patient is eligible for New Jersey FamilyCare, the designated employee shall assist the patient in beginning enrollment into the FamilyCare program using the State's presumptive eligibility process.  If the employee is unable to assist in the enrollment process, or if the patient does not wish to begin the process at the time of the interview, the employee shall provide the patient with appropriate information on the FamilyCare program.

 

     2.    This act shall take effect on the 30th day after the date of enactment.

 

 

STATEMENT

 

     This bill would require that designated hospital employees who have satisfied certain training requirements assist uninsured patients to create an account for the patient to access the Federally-Facilitated Marketplace established pursuant to the federal "Patient Protection and Affordable Care Act," Pub.L.111-148, as amended by the federal "Health Care and Education Reconciliation Act of 2010," Pub.L.111-152, also known as "Obamacare."  The designated employee would be required to provide additional information concerning the Federally-Facilitated Marketplace and, if authorized to do so, may also assist the patient with obtaining health insurance through the Federally-Facilitated Marketplace.

     Prior to a patient's discharge from a hospital, the designated employee would interview the patient, or the patient's family member or guardian if the patient is unavailable, to determine whether the patient has health insurance coverage and to obtain documentation of any coverage.  If it is determined that the patient does not have insurance coverage, the designated hospital employee would assist the patient to create an account enabling the patient to access the Federally-Facilitated Marketplace website.

     If the patient's request for care occurs during the open enrollment period for purchasing health insurance through the Federally-Facilitated Marketplace, the employee may, to the extent permitted by law, assist the patient with registering an account with the Marketplace website.  If the employee is registered as a Navigator, Certified Application Counselor, or is otherwise permitted by State and federal law to assist individuals in enrolling in a health insurance plan, the employee would offer assistance to the patient in applying for potential subsidies and enrolling in a qualified health plan of the patient's choice.  An employee not designated to provide assistance in enrollment would be permitted to refer the patient to an appropriate staff member or entity to continue the enrollment process.

     If the patient's request for care does not occur during the open enrollment period, if the designated employee is not registered or permitted by law or is otherwise unable to provide such assistance, if the patient chooses not to purchase insurance through the Federally-Facilitated Marketplace, or if the patient does not obtain insurance through the Marketplace for any other reason, the designated employee would provide the patient, family member, or guardian with information about resources available to assist the patient in navigating the Marketplace website, purchasing health insurance through the Marketplace, and the dates of the next open enrollment period.

     If it is determined during the patient's discharge interview that the patient is eligible for New Jersey FamilyCare, the designated employee would assist the patient in beginning enrollment into the FamilyCare program using the State's presumptive eligibility process.  If the employee is unable to assist in the enrollment process, or if the patient does not wish to begin the process at the time of the interview, the employee would provide the patient with the appropriate information on the FamilyCare program.

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