New Jersey Assembly Bill A1451

New Jersey 2022-2023 Regular Session

• Introduced: 1/11/22
• Refer: 1/11/22

Caption

Requires health benefits coverage for private duty nursing services.

Impact

The implementation of A1451 will significantly alter how health benefits are structured in relation to private duty nursing. Insurers will be required to include these services in their coverage plans, which could lead to increased access to necessary care for patients who need more individualized attention. However, the services will still fall under the same deductibles and cost-sharing parameters that apply to similar services, meaning patients may still incur notable out-of-pocket expenses. The bill also permits insurers to require prior authorization for these nursing services, potentially impacting accessibility.

Summary

Assembly Bill A1451 aims to require health insurers in New Jersey to provide health benefits coverage for private duty nursing services. This legislation mandates that all contracts issued, executed, or renewed on or after the bill's effective date must include provisions for coverage of these nursing services. The bill defines 'private duty nursing services' as those requiring more personalized and continuous care than what is standard from visiting nurses or hospital staff. It outlines that these services can be provided in multiple settings, including recipients' homes, hospitals, or skilled nursing facilities.

Contention

Debate around A1451 may arise regarding the potential increase in insurance premiums due to the expanded coverage requirements. Stakeholders including healthcare professionals and patient advocacy groups may support the bill for its potential to enhance patient care, while insurance companies might express concerns over cost implications. The requirement for prior authorization could also lead to delays in receiving care, raising concerns about the bill's effectiveness in improving patient outcomes.