Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
SYNOPSIS
Requires health insurers to cover costs of tobacco use cessation services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health benefits coverage for tobacco use cessation services and supplementing Titles 17 and 26 of the Revised Statutes and Title 17B of the New Jersey Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. A hospital service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 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 for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
2. A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 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 for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
3. A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 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 for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.
4. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 27 of Title 17B of the New Jersey Statutes, 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 for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
5. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, 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 for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
6. A health maintenance organization contract that provides health care services and is delivered, issued, executed or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 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 health care services for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for enrollees who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The health care services shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to those 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. An individual health benefits plan required pursuant to section 3 of P.L.1992, c.161 (C.17B:27A-4) that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide coverage for expenses incurred for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium.
8. A small employer health benefits plan required pursuant to section 3 of P.L.1992, c.162 (C.17B:27A-19) that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide coverage for expenses incurred for counseling for cessation of tobacco use.
As used in this section, "counseling for cessation of tobacco use" means diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the United States Public Health Service in June 2000, or any subsequent modification thereof, and such other services as the United States Secretary of Health and Human Services may recognize as effective for this purpose through public written notice.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
This section shall apply to all small employer health benefits plans in which the carrier has reserved the right to change the premium.
9. This act shall take effect on the first day of the seventh month next following the date of enactment and shall apply to policies or contracts issued or renewed on or after the effective date.
STATEMENT
This bill requires health insurers in New Jersey to cover tobacco use cessation services recommended by the Public Health Service in the United States Department of Health and Human Services.
The requirements of the bill would apply to hospital, medical and health service corporations, commercial individual, small employer and group health insurers, and health maintenance organizations.
The services covered under this bill would include: diagnostic, therapy and counseling services for cessation of tobacco use, for covered persons who use tobacco products or are being treated for tobacco use, which are furnished by or under the supervision of a physician and are limited to those services recommended in "Treating Tobacco Use and Dependence: A Clinical Practice Guideline," published by the Public Health Service in June 2000, or any subsequent modification thereof, and other services recognized by the Secretary of Health and Human Services as effective for this purpose through public written notice.
The bill takes effect on the first day of the seventh month following the date of enactment and applies to policies and contracts issued or renewed on or after the effective date.
Although tobacco use is the leading cause of premature morbidity and mortality in the United States (resulting in over 400,000 deaths in this country each year), insurance coverage for cessation services is uncommon. According to the federal Centers for Disease Control and Prevention, the relatively high cost of, and lack of insurance coverage for, effective smoking cessation treatments present some of the most formidable obstacles that low-income smokers face in attempting to quit. There is evidence that providing insurance coverage for cessation programs saves lives and money, and the United States Surgeon General has established the provision of insurance coverage for effective tobacco dependence treatments in all 50 states and the District of Columbia as one of the objectives included in the "Healthy People 2010" initiative.
This bill is designed to make this critical health wellness benefit accessible to insured persons in this State who are attempting to free themselves from their dependence on tobacco.