ASSEMBLY APPROPRIATIONS COMMITTEE

STATEMENT TO

ASSEMBLY, No. 4935

with committee amendments

STATE OF NEW JERSEY

DATED:  MARCH 18, 2019

      The Assembly Appropriations Committee reports favorably Assembly Bill No. 4935, with committee amendments.

      As amended, this bill prohibits the health benefits coverage of certain non-medically indicated early elective deliveries under the Medicaid Program, the State Health Benefits Program (SHBP), and the School Employees’ Health Benefits Program (SEHBP).  Specifically, this bill prohibits health benefits contracts which are issued or purchased pursuant to the SHBP, SEHBP, and the Medicaid Program, as well as services purchased under the fee-for-service delivery system within the Medicaid Program, from providing health benefits coverage or reimbursing a provider for a non-medically indicated early elective delivery performed at a hospital on a pregnant woman earlier than the 39th week of gestation.

      As used in the bill, “non-medically indicated early elective delivery” means the artificial start of the birth process through medical interventions or other methods, also known as labor induction, or the surgical delivery of a baby via a cesarean section for purposes or reasons that are not fully consistent with established standards of clinical care as provided by the American College of Obstetricians and Gynecologists (ACOG).

COMMITTEE AMENDMNETS:

      The committee amended the bill to:

      enhance the findings and declarations section;

      to delay the effective date of certain provisions of the bill;

      to require, during the period of the bill’s delayed effect, the Division of Medical Assistance and Health Services to provide accessible educational materials to inform pregnant women, their support networks, and Medicaid providers about the risks of  non-medically indicated early elective delivery.

FISCAL IMPACT:

The provisions of this bill will result in health benefit cost reductions within the Medicaid Program, the State Health Benefits Program, and the School Employees’ Health Benefits Program.  Under the bill, early elective deliveries (EED’s) will no longer be covered by these programs.  However the savings cannot be quantified with any certainty as 1) the actual cost for these services is unknown and 2) the number of individuals who would no longer have an early elective delivery is unpredictable.