SENATE HEALTH COMMITTEE

STATEMENT TO

SENATE, No. 789

with committee amendments

STATE OF NEW JERSEY

DATED: DECEMBER 11, 1997

      The Senate Health Committee reports favorably and with committee amendments Senate Bill No. 789.

      As amended by committee, this bill provides that health service corporations, medical service corporations and commercial individual and group insurers must 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 receive direct reimbursement from third party payers because they are not specifically listed as qualified providers under the pertinent statutes. This bill changes current law by including 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.

      The committee adopted a technical amendment to section 6 of the bill to conform its language to Assembly Bill No. 1418. As amended, this bill is identical to Assembly Bill No. 1418 (Garrett/Augustine), which the committee also reported favorably on this date.