ASSEMBLY INSURANCE COMMITTEE

STATEMENT TO

ASSEMBLY, No. 1418

STATE OF NEW JERSEY

DATED: FEBRUARY 15, 1996

      The Assembly Insurance Committee reports favorably Assembly Bill No. 1418.

      This bill requires health service corporations (Blue Cross and Blue Shield of New Jersey), medical service corporations, and commercial individual and group insurers to reimburse licensed audiologists and speech-language pathologists for services that they perform for insureds if those services are eligible services under the policy or contract.

      Under current law, audiologists and speech-language pathologists who practice in a hospital or other institution, by virtue of the setting of their practice, are considered to be qualified providers, and are therefore eligible for direct reimbursement by health insurers. Licensed audiologists and speech-language pathologists in private practice, however, cannot be directly reimbursed by third party payers because they are not specifically listed as qualified providers under the pertinent statutes. This bill changes current law to include licensed audiologists and speech-language pathologists in the pertinent statutes as qualified providers, and thus makes them eligible for direct reimbursement.

      The bill also requires the board of directors of the New Jersey Small Employer Health Benefits Program to consider including benefits for speech-language-pathology and audiology services in at least one of the five standard policies and in at least one of the five riders to be developed by the board.