Bill Text: NJ A5271 | 2024-2025 | Regular Session | Introduced
Bill Title: Requires health insurance coverage of scalp cooling systems in connection with cancer chemotherapy treatment; requires physicians to inform patients of scalp cooling therapy.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2025-02-10 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A5271 Detail]
Download: New_Jersey-2024-A5271-Introduced.html
Sponsored by:
Assemblywoman TENNILLE R. MCCOY
District 14 (Mercer and Middlesex)
SYNOPSIS
Requires health insurance coverage of scalp cooling systems in connection with cancer chemotherapy treatment; requires physicians to inform patients of scalp cooling therapy.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning scalp cooling therapy in connection with cancer chemotherapy treatment and supplementing various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
2. a. 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
3. a. 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the policy.
c. This section shall apply to those individual health insurance policies in which the insurer has reserved the right to change the premium.
d. As used in this section, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the policy.
c. This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium.
d. As used in this section, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
6. a. An individual 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.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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
7. 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.), 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
8. a. A health maintenance organization contract for health care services that 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, and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
c. This section shall apply to those contracts for health care services 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, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
9. a. 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 and medical expense benefits and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
c. As used in this section, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
10. a. 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 and medical expense benefits and includes coverage for cancer chemotherapy treatment shall also provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
b. The benefits shall be provided to the same extent as for any other condition under the contract.
c. As used in this section, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
11. a. A physician administering cancer chemotherapy to a patient shall inform the patient, prior to the initiation of treatment, of the availability of scalp cooling therapy as an option to help prevent or reduce hair loss.
b. Documentation of this discussion shall be included in the patient's medical record.
12. This act shall take effect on the 180th day following enactment, and sections 1 through 10 shall apply to contracts delivered, issued, executed, or renewed on or after that date.
STATEMENT
This bill requires health insurance carriers (insurance companies, health, hospital, and medical service corporations, health maintenance organizations, and State and School Employees' Health Benefits Program contracts) to provide coverage for scalp cooling systems used in connection with cancer chemotherapy treatment.
Pursuant to the bill, "scalp cooling system" means any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, so long as the device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.
In addition, the bill requires physicians administering cancer chemotherapy to a patient to inform the patient, prior to the initiation of treatment, of the availability of scalp cooling therapy as an option to help prevent or reduce hair loss and to maintain a record of the discussion in the patient's medical records.
