Bill Text: NJ A3909 | 2016-2017 | Regular Session | Amended
Bill Title: Requires hospital laboratories and bio-analytical or clinical laboratories to offer test for hepatitis C to certain individuals; authorizes certain laboratories to perform rapid tests for hepatitis C.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Engrossed - Dead) 2017-01-09 - Received in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [A3909 Detail]
Download: New_Jersey-2016-A3909-Amended.html
ASSEMBLY, No. 3909
STATE OF NEW JERSEY
217th LEGISLATURE
INTRODUCED SEPTEMBER 8, 2016
Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
Assemblywoman ANGELA V. MCKNIGHT
District 31 (Hudson)
SYNOPSIS
Requires hospital laboratories and bio-analytical or clinical laboratories to offer test for hepatitis C to certain individuals; authorizes certain laboratories to perform rapid tests for hepatitis C.
CURRENT VERSION OF TEXT
As amended by the General Assembly on October 20, 2016.
An Act concerning hepatitis C testing and supplementing Title 26 and Title 45 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The Legislature finds and declares that:
a. According to the federal Centers for Disease Control and Prevention (CDC), approximately 75 percent of the 3.2 million people chronically infected with hepatitis C in the United States were born between 1945 and 1965. The CDC estimates that people born during these years are five times more likely than other adults to be infected with hepatitis C.
b. The CDC notes that hepatitis C is the leading cause of both liver cancer and liver transplants, and estimates that people born between 1945 and 1965 account for 73 percent of all hepatitis C-related mortality.
c. Studies suggest that between 45 percent and 85 percent of people infected with hepatitis C are unaware they are infected, and as many as 50 percent of hepatitis C infections may go undetected under the current hepatitis C risk factor screening standards.
d. The CDC recommends one-time testing of all people born between 1945 and 1965 for hepatitis C infection, suggesting that this testing is likely to identify approximately 800,000 people infected with hepatitis C.
e. Proactively testing for hepatitis C infection among persons born between 1945 and 1965 may help stop progression of the disease, increase the effectiveness of treatment, and reduce the duration of therapy for those infected, potentially resulting in improved health outcomes and significant cost reductions associated with treating liver disease.
f. New Jersey can help promote efforts to diagnose and treat hepatitis C infection by facilitating access to hepatitis C screening tests at certain points of care for persons born between 1945 and 1965.
2. a. As used in this section 1[, "hepatitis] :
"Carrier" means an insurer licensed to write health insurance in this State under Title 17 of the Revised Statutes or Title 17B of the New Jersey Statutes and a health maintenance organization licensed pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), or a carrier acting as a third party administrator on behalf of an employer or other entity under a self-funded plan.
"Employer" means and includes a self-funded business or other entity that pays claims directly without using a licensed third party administrator.
"Health benefits plan" means a benefits plan which pays or provides hospital and medical expense benefits and other health care services for covered services, and is delivered or issued for delivery in this State by or through a carrier, or an employer or third party administrator that pays hospital and medical benefits. For the purposes of this section, "health benefits plan" shall not include the following plans, policies or contracts: Medicaid, Medicare, Medicare Advantage, accident only, credit, disability, long-term care, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.), a dental plan as defined pursuant to section 1 of P.L.2014, c.70 (C.26:2S-26) and hospital confinement indemnity coverage.
"Hepatitis1 C screening test" means a test approved by the federal Food and Drug Administration that detects the presence of hepatitis C virus antibodies in the blood.
1"Self-funded health benefits plan" means a health benefits plan in which payment to providers of health services is paid directly to providers on behalf of covered persons from an employer's or other entity's funds, either by the employer directly or through the use of a licensed third party administrator, with no transfer of risk to a carrier or other party.
"Third party administrator" means an entity licensed pursuant to P.L.2001, c.267 (C.17B:27B-1 et seq.) that disburses payment for health benefits to providers for covered services on behalf of a self-funded health benefits plan.1
b. Pursuant to a standing order issued by its chief medical officer, a general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), when providing laboratory services on an 1[inpatient or]1 outpatient basis to an individual who was born between January 1, 1945 and December 31, 1965, shall 1, upon registration,1 provide the individual with a verbal and written statement of CDC policy regarding 1[Hepatitis] hepatitis1 C screening, and offer to provide a hepatitis C screening test to that individual. If the individual consents to undergo a hepatitis C screening test pursuant to this subsection, the hospital laboratory shall perform the hepatitis C screening test and transmit the test results to the health care provider rendering the referral for laboratory services. 1The standing order shall designate a process for an appropriate member of the hospital staff to contact an individual who tests positive for hepatitis C in a screening test performed pursuant to this subsection, so as to advise the individual of the test results and encourage the individual to seek appropriate follow-up care.1
c. Pursuant to a standing order issued by its chief medical officer or an equivalent officer, a bio-analytical or clinical laboratory, when providing laboratory services to an individual born between January 1, 1945 and December 31, 1965 who was referred for laboratory services by a health care professional licensed pursuant to Title 45 of the Revised Statutes, shall 1, upon registration,1 provide the individual with a verbal and written statement of CDC policy regarding Hepatitis C screening and offer to provide a hepatitis C screening test to that individual. If the individual consents to undergo a hepatitis C screening test pursuant to this subsection, the laboratory shall perform the hepatitis C screening test and transmit the test results to the health care professional who provided the referral for laboratory services.
d. This section shall not affect the scope of practice of any health care professional or diminish any authority or legal or professional obligation of any health care professional to offer a hepatitis C screening 1[or diagnostic]1 test, or to provide services or health care for the individual who is subject to a hepatitis C screening 1[or diagnostic]1 test.
1e. A hospital, bio-analytical, or clinical laboratory shall not be required to provide an individual with a statement of CDC policy regarding hepatitis C screening and offer to provide a hepatitis C screening test to the individual pursuant to this section if, upon a review of the laboratory's records, it is determined the individual has already been tested for hepatitis C.
f. (1) In the event that a laboratory that performs a hepatitis C screening test pursuant to subsection b. or c. of this section is out-of-network with respect to a covered person's health benefits plan, or the health benefits plan does not otherwise provide coverage for the screening test, the carrier shall reimburse the laboratory for the cost of the screening test at the carrier's in-network rate, or in any other reasonable amount as agreed upon by the laboratory and the carrier, less any applicable copayment, coinsurance, or deductible. In no case shall the laboratory bill the covered person for the difference between the in-network and out-of-network rates for the screening test, or for any amount in excess of an amount otherwise agreed upon by the laboratory and the carrier, except that the covered person shall be responsible for any applicable copayment, coinsurance, or deductible.
(2) Paragraph (1) of this subsection shall not apply to a hepatitis C screening test that is performed on a covered person in the event that, prior to the performance of the screening test:
(a) a check of laboratory records pursuant to subsection e. of this section determines that the covered person was previously tested for hepatitis C;
(b) the covered person is advised that, because the person was previously tested for hepatitis C, the person may be liable for all or part of the cost of the screening test in the event the person's health benefits plan does not provide coverage for the test; and
(c) the person, voluntarily and in writing, requests or agrees to undergo the hepatitis C screening test.
g. The Commissioner of Health shall evaluate the impact of the provisions of this section with respect to the number of individuals who are screened for hepatitis C and the number of individuals who have accessed care following a positive test. No later than one year after the effective date of this act, the Commissioner of Health shall submit a report of the evaluation to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature.1
3. The Commissioner of Health, in consultation with the Public Health Council in the Department of Health, shall adopt regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to permit any laboratory site that has a current Clinical Laboratory Improvement Amendments Certificate of Waiver issued by the federal Centers for Medicare & Medicaid Services to perform rapid point-of-care tests for hepatitis C virus licensed by the federal Food and Drug Administration.
4. The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to effectuate the purposes of this act.
5. This act shall take effect on the first day of January next following the date of enactment, except that the Commissioner of Health may take such anticipatory administrative action in advance of the effective date as shall be necessary for the implementation of this act. Section 1 of this act shall expire and be deemed repealed on January 1 of the fifth year next following the date of enactment.
