STATE OF NEW JERSEY
221st LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2024 SESSION
Sponsored by:
Assemblywoman TENNILLE R. MCCOY
District 14 (Mercer and Middlesex)
SYNOPSIS
Prohibits pre-approval or precertification of prenatal ultrasound screenings covered under health benefits plans.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning pre-approval and precertification of certain ultrasound screenings and supplementing various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Notwithstanding the provisions of any other law, rule or regulation to the contrary, a carrier shall not condition the payment of any benefit for a prenatal ultrasound screening upon any pre-approval or precertification of any kind by the carrier if that prenatal ultrasound screening is otherwise covered under the health benefits plan and it has been prescribed by a licensed health care provider.
2. Notwithstanding the provisions of any other law, rule or regulation to the contrary, a third party administrator shall not condition the payment of any benefit for a prenatal ultrasound screening upon any pre-approval or precertification of any kind by the third party administrator or benefits payer if that prenatal ultrasound screening is otherwise covered under the health benefits plan and it has been prescribed by a licensed health care provider.
3. Notwithstanding the provisions of any other law, rule or regulation to the contrary, a contract for health benefits purchased by the State Health Benefits Program shall not condition the payment of any benefit for a prenatal ultrasound screening upon any pre-approval or precertification of any kind if that prenatal ultrasound screening is otherwise covered under the health benefits plan and it has been prescribed by a licensed health care provider.
4. Notwithstanding the provisions of any other law, rule or regulation to the contrary, a contract for health benefits purchased by the School Employees' Health Benefits Program shall not condition the payment of any benefit for a prenatal ultrasound screening upon any pre-approval or precertification of any kind if that prenatal ultrasound screening is otherwise covered under the health benefits plan and it has been prescribed by a licensed health care provider.
5. This act shall take effect immediately and apply to health benefits plans issued or purchased on or after that date.
STATEMENT
This bill prohibits health insurers, third party administrators, and the State Health Benefits Program and the School Employees' Health Benefits Program from requiring the pre-approval or precertification of prenatal ultrasound screenings covered under a health benefits plan.