SENATE HEALTH COMMITTEE

 

STATEMENT TO

 

SENATE, No. 1561

 

with committee amendments

 

STATE OF NEW JERSEY

 

DATED: MARCH 20, 1997

 

      The Senate Health Committee reports favorably Senate Bill No. 1561 with committee amendments.

      As amended by committee, this bill requires hospital, medical and health service corporations, commercial insurers and health maintenance organizations to develop guidelines which establish the carrier's policy for determining when bone density tests are medically indicated, and to provide benefits for bone density tests that are performed in accordance with the guidelines. At a minimum, the guidelines shall take into account co-existing medical conditions, family history and lifestyle practices and medications that place a patient at risk for osteoporosis. The carrier shall make the guidelines available to a health care provider upon request. The bill exempts individual and small employer health benefits plans issued pursuant to P.L.1992, c.161 and c.162, respectively, from this coverage requirement.

      The committee amended the bill to require carriers to develop guidelines which establish the carrier's policy for determining when bone density tests are medically indicated and to provide benefits for bone density tests performed in accordance with the guidelines, rather than provide the broader mandate that a carrier provide benefits for bone density tests performed in connection with the diagnosis or treatment of osteoporosis, as the bill originally provided.