New Jersey Statutes

The Act amends NJRS to require plans to provide coverage for  medically necessary behavioral health care services and autism services and to comply with the Federal Parity law. The Act amends NJRS C.17:48-6v, C.17:48A-7u, C.17:48E-35.20, C.17B:26-2.1s, C.17B:27-46.1v, C.17B:27A-7.5, C.17B:27A-19.7, C.26:2J-4.20, C.52:14-17.29e respectively, to require the above of individual and group hospital service corporation contracts; individual and group medical service corporation contracts; individual and group health service corporation contracts; individual health insurance policies; group health insurance policies; individual health benefit plans; small employer health benefit plans; every enrollee agreement delivered, issued, executed, or renewed in this approved for issuance or renewal by the Commissioner of Banking and Insurance; and every contract purchased by the State Health Benefits Commission.
Lastly, the Act amends NJRS by adding a new section to create reporting requirements for the above listed insurers to submit detailed retrospective rates and NQTL parity compliance analyses using specific guidelines and processes to certify the plan is in compliance with parity requirements. The Department of Banking and Insurance must implement and enforce parity requirement, post on their website analysis of the plan’s reports, and submit to the legislature a report detailing enforcement, oversight, correctional, and educational efforts and actions taken to ensure compliance with MHPAEA and state statutes.

Enacted through A2031/S1339

The State Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date [May 16, 2017] of this act provides unlimited benefits for inpatient and outpatient treatment of substance use disorder at in-network facilities. The services for the treatment of substance use disorder shall be prescribed by a licensed physician, licensed psychologist, or licensed psychiatrist and provided by licensed health care professionals or licensed or certified substance use disorder providers in licensed or otherwise State-approved facilities, as required by the laws of the state in which the services are rendered.

Enacted by N.J. S.B. 3.