A1470

An Act concerning health benefits coverage for donated human breast milk 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 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of 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 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of 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 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of 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 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of this section shall apply to those policies in which the insurer has reserved the right to change the premium.

5. a. 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of this section shall apply to those policies in which the insurer has reserved the right to change the premium.

6. a. An individual health benefits plan 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of this section shall apply to those individual 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 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of this section shall apply to those small employer health benefits plans in which the carrier has reserved the right to change the premium.

8. a. A health maintenance organization 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 expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

b. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the health maintenance organization has reserved the right to change the schedule of charges.

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 in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

10. The School Employees’ 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 in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

11. This act shall take effect on the 90th day after enactment.

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 health benefits coverage for any expenses incurred in the provision of donated human breast milk provided that:

(1) the covered person is an infant under the age of six months;

(2) a physician prescribes the milk for the covered person; and

(3) the milk is obtained from a human milk bank that meets quality guidelines established by the Human Milk Banking Association of North America, or that is licensed by the Department of Health.

The Human Milk Banking Association of North America is a national professional organization that supports non-profit human milk banking. It works to ensure the quality of human milk banks through the establishment of mandatory guidelines and periodic inspections of human milk banks.