Bill Text: NJ S3131 | 2024-2025 | Regular Session | Introduced
Bill Title: Requires DOH to expand services provided under plan to improve perinatal mental health services and health insurers to cover costs of perinatal mood and anxiety disorder screening.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced) 2024-04-15 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S3131 Detail]
Download: New_Jersey-2024-S3131-Introduced.html
Sponsored by:
Senator M. TERESA RUIZ
District 29 (Essex and Hudson)
SYNOPSIS
Requires DOH to expand services provided under plan to improve perinatal mental health services and health insurers to cover costs of perinatal mood and anxiety disorder screening.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning perinatal mental health care, amending P.L.2021, c.380, and supplementing various parts of statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2021, c.380 (C.26:2-178.1) is amended to read as follows:
1. a. The Department of Health, in consultation with the Perinatal Mental Health Coalition of New Jersey and the Maternal Child Health Consortia, shall develop and implement a plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services.
b. The plan shall provide strategies to:
(1) increase awareness among mental health care service providers who treat women experiencing perinatal mood and anxiety disorders with regard to the prevalence and effects of perinatal mood and anxiety disorders on women and children;
(2) establish a referral network of mental health care providers and support services for women who are in need of perinatal mood and anxiety disorder treatment while planning a pregnancy, during pregnancy, prior to giving birth, and throughout the first year after pregnancy;
(3) increase women's access to formal and informal peer support services, including access to certified peer specialists who have received training related to perinatal mood and anxiety disorders;
(4) raise public awareness for, and reduce the stigma related to, perinatal mood and anxiety disorders; [and]
(5) provide available funds to perinatal mood and anxiety disorder screening, referral, treatment, and support services;
(6) insure that women planning a pregnancy and women who are about to give birth are screened for perinatal mood and anxiety disorder risk factors, as determined by the Perinatal Mental Health Coalition of New Jersey;
(7) implement a standardized process to collect data concerning all perinatal mood and anxiety disorder screening, referral, treatment, and support services provided in an outpatient setting, and to forward such data for inclusion as a Pregnancy Risk Assessment Monitoring System (PRAMS) dataset query on the New Jersey State Health Assessment Data (NJSHAD) System;
(8) implement a perinatal mental health continuing education requirement for all health care professionals and certified peer specialists who provide perinatal treatment and care to pregnant women, women who have recently given birth, and the parent or parents of a newborn infant; and
(9) require the department prepare a resource guide that provides information on the:
(a) perinatal mood and anxiety disorder screening, referral, treatment, and support services available to women planning a pregnancy, pregnant women, women who are about to give birth, women have recently given birth, and the parent or parents of a newborn infant born in this State; and
(b) mental health providers and certified peer specialists who provide such services.
c. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
(cf: P.L.2021, c.380)
2. (New section) a. A hospital service corporation which provides hospital or medical expense benefits under a contract that is delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
d. As used in this section,
"perinatal mood and anxiety disorders" means a spectrum of emotional or mental
health complications that affect an expectant or new parent at any point during
pregnancy and throughout the first year after pregnancy.
3. (New section) a. A medical service corporation which provides
hospital or medical expense benefits under a contract that is delivered,
issued, executed, or renewed in this State or approved for issuance or renewal
in this State by the Commissioner of Banking and Insurance, on or after the
effective date of this act, shall provide coverage for expenses incurred in
screening women for perinatal mood and anxiety disorders, as required by the
plan to improve access to perinatal mood and anxiety disorder screening,
referral, treatment, and support services developed and implemented by the
Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1),
during preconception, pregnancy, prior to giving birth, and throughout the
first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
4. (New section) a. A health service corporation which provides hospital or medical expense benefits under a contract that is delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
5. (New section) a. An individual health insurance policy which provides hospital or medical expense benefits under a policy that is delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those policies in which the insurer has reserved the right to change the premium.
d. As used in this section,
"perinatal mood and anxiety disorders" means a spectrum of emotional or mental
health complications that affect an expectant or new parent at any point during
pregnancy and throughout the first year after pregnancy.
6. (New section) a. An individual health benefits plan that is
delivered, issued, executed, renewed, or approved for issuance or renewal in
this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for
issuance or renewal in this State by the Commissioner of Banking and Insurance,
on or after the effective date of this act, shall provide coverage for expenses
incurred in screening women for perinatal mood and anxiety disorders, as
required by the plan to improve access to perinatal mood and anxiety disorder
screening, referral, treatment, and support services developed and implemented
by the Department of Health pursuant to section 1 of P.L.2021, c.380
(C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and
throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the health benefits plan and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
7. (New section) a. A small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), on or after the effective date of this act, shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other condition under the health benefits plan and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
8. (New section) a. A group health insurance policy which provides hospital or medical expense benefits under a policy that is delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. This section shall apply to those policies in which the insurer has reserved the right to change the premium.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
9. (New section) a. A certificate of authority to establish and operate a health maintenance organization in this State shall not be issued or continued on or after the effective date of this act by the Commissioner of Banking and Insurance unless the health maintenance organization shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
d. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
10. (New section) a. Notwithstanding any State law or regulation to the contrary, the Division of Medical Assistance and Health Services in the Department of Human Services shall, contingent on maintaining or receiving necessary federal approvals, ensure coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
d. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this section and to secure federal financial participation for State expenditures under the federal Medicaid program.
11. (New section) a. Notwithstanding any other provision of law to the contrary, the State Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital or medical expense benefits shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
12. (New section) a. Notwithstanding any other provision of law to the contrary, the School Employees' Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital or medical expense benefits shall provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1), during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy.
b. This benefit shall be provided to the same extent as for any other medical condition under the contract and shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(1) 99401-99404 Preventive medicine, individual counseling;
(2) 99411-99412 Preventive medicine, group counseling;
(3) 99201-99205 New patient, office or other outpatient visit; and
(4) 99211-99215 Established patient, office or other outpatient visit.
c. As used in this section, "perinatal mood and anxiety disorders" means a spectrum of emotional or mental health complications that affect an expectant or new parent at any point during pregnancy and throughout the first year after pregnancy.
13. (New section) A health care professional or a certified peer specialist who has received training related to perinatal mental health care services and provides perinatal treatment and care to pregnant women, women who have recently given birth, or the parent or parents of a newborn infant shall complete a continuing education course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant to section 1 of P.L.2021, c.380 (C.26:2-178.1).
14. (New section) A certified peer specialist trained by the University Behavioral HealthCare of Rutgers, the State University, the Mental Health Association in New Jersey, or another entity to provide services related to perinatal mental health to pregnant women, women who have recently given birth, or the parent or parents of a newborn infant, as a condition of certification, shall complete at least one credit of a continuing educational course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant of section 1 of P.L.2021, c.380 (C.26:2-178.1).
15. (New section) The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician who provides perinatal treatment and care to pregnant persons, as a condition of biennial registration pursuant to section 1 of P.L.1971, c.236 (C.45:9-6.1), include one credit of a continuing educational course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant of section 1 of P.L.2021, c.380 (C.26:2-178.1).
16. (New section) The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician assistant who provides perinatal treatment and care to pregnant persons, as a condition of biennial renewal pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13), include one credit of a continuing educational course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant of section 1 of P.L.2021, c.380 (C.26:2-178.1).
17. (New section) The New Jersey Board of Nursing shall require that the number of credits of continuing education required of each person licensed as a professional nurse or a practical nurse who provides perinatal treatment and care to pregnant persons, as a condition of biennial license renewal, include one credit of a continuing educational course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant of section 1 of P.L.2021, c.380 (C.26:2-178.1).
18. (New section) A certified nurse midwife, certified professional midwife, or certified midwife who was licensed prior to the effective date of this act shall, as a condition of license renewal, complete one credit of a continuing educational course on perinatal mental health as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the Department of Health pursuant of section 1 of P.L.2021, c.380 (C.26:2-178.1).
19. This act shall take effect on the first day of the fourth month next following the date of enactment. Sections 2 through 12 of this act shall apply to all contracts and policies that are delivered, issued, executed, or renewed, or approved for issuance or renewal in this State on or after the effective date.
STATEMENT
This bill requires the Department of Health (DOH) to expand services provided under the plan to improve access to perinatal mood and anxiety disorder screening developed and implemented pursuant to P.L.2021, c.380 (C.26:2-178.1 et seq.).
Specifically, the bill amends section 1 of P.L.2021, c.380 (C.26:2-178.1) to mandate that the Perinatal Mental Health Coalition of New Jersey and the Maternal Child Health Consortia consult with the DOH to develop and implement the plan to improve access to perinatal mood and anxiety disorder screening required under the provisions the law.
The bill also amends the law to mandate that the plan also include strategies to: (1) expand the referral network of mental health care providers and support services to serve women: planning a pregnancy; during pregnancy, during the time period prior to giving birth; and during the first year after a woman's pregnancy; (2) insure that women planning a pregnancy and women who are about to give birth are screened for perinatal mood and anxiety disorder risk factors; (3) implement a standardized process to collect data concerning all perinatal mood and anxiety disorder screening, referral, treatment, and support services provided in an outpatient setting; (4) implement a perinatal mental health continuing education requirement for all health care professionals and certified peer specialists who provide perinatal treatment and care; and (5) require the DOH prepare a perinatal mood and anxiety disorder screening, referral, treatment, and support services resource guide.
The bill stipulates that a health care professional or a certified peer specialist who has received training related to perinatal mental health care services and provides perinatal treatment and care to pregnant women, women who have recently given birth, or the parent or parents of a newborn infant is to complete a continuing education course on perinatal mental health.
Under the bill's provisions, the State Board of Medical Examiners and the New Jersey Board of Nursing are to require that the number of credits of continuing medical education required of the health care professionals licensed or certified by the respective boards, who provide perinatal treatment and care, to include one credit of a continuing educational course on perinatal mental health, as a condition of license or certification renewal.
The bill also requires health insurers to provide coverage for expenses incurred in screening women for perinatal mood and anxiety disorders, as required by the plan to improve access to perinatal mood and anxiety disorder screening, referral, treatment, and support services developed and implemented by the DOH, during preconception, pregnancy, prior to giving birth, and throughout the first year after pregnancy. Specifically, this provision of the bill affects health, hospital, and medical service corporations; individual and group health insurance policies; health maintenance organizations; individual health benefits plans; small employer health benefits plans; the State Health Benefits Program; the School Employees' Health Benefits Program; and the State Medicaid Program.
