ASSEMBLY, No. 201

STATE OF NEW JERSEY

Introduced Pending Technical Review by Legislative Counsel

PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

By Assemblywomen WEINBERG and HECK

An Act requiring health insurance benefits for expenses incurred for bone density tests in connection with the diagnosis or treatment of osteoporosis and supplementing P.L.1938, c.366 (C.17:48-1 et seq.), P.L.1940, c.74 (C.17:48A-1 et seq.), P.L.1985, c.236 (C.17:48E-1 et seq.), chapters 26 and 27 of Title 17B of the New Jersey Statutes and P.L.1973, c.337 (C.26:2J-1 et seq.).

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

    1. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), every group or individual hospital service corporation contract providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance on or after the effective date of this act, shall provide benefits for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. Benefits for such tests shall be provided to the same extent as for any other illness under the contract.

    This section shall apply to all hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.

    2. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), every group or individual medical service corporation contract providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance on or after the effective date of this act, shall provide benefits for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. Benefits for such tests shall be provided to the same extent as for any other illness under the contract.

    This section shall apply to all medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.

    3. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), every group or individual health service corporation contract providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance on or after the effective date of this act, shall provide benefits for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. Benefits for such tests shall be provided to the same extent as for any other illness under the contract.

    This section shall apply to all health service corporation contracts in which the health service corporation has reserved the right to change the premium.

    4. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) every individual policy providing health insurance coverage delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance on or after the effective date of this act, shall provide benefits for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. Benefits for such tests shall be provided to the same extent as for any other illness under the policy.

    This section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium.

    5. Except as otherwise provided in P.L.1992, c.162 (C.17B:27A-17 et seq.), every group policy providing health insurance coverage delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance on or after the effective date of this act, shall provide benefits for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. Benefits for such tests shall be provided to the same extent as for any other illness under the policy.

    This section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium.

    6. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), no certificate of authority to establish and operate a health maintenance organization in this State shall be issued or continued on or after the effective date of this act unless the health maintenance organization provides health care services for any enrollee for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis. These health care services shall be provided to the same extent as for any other sickness.

    The provisions of this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.

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

STATEMENT

    This bill requires hospital service corporations (Blue Cross), medical service corporations (Blue Shield), health service corporations (Blue Cross and Blue Shield of New Jersey), commercial insurers and health maintenance organizations to provide coverage for bone density tests which are performed in connection with the diagnosis or treatment of osteoporosis.

Requires health insurers to provide coverage for bone density tests in connection with diagnosis or treatment of osteoporosis.