ASSEMBLY, No. 4929 STATE OF NEW JERSEY 221st LEGISLATURE INTRODUCED OCTOBER 21, 2024
ASSEMBLY, No. 4929
STATE OF NEW JERSEY
221st LEGISLATURE
INTRODUCED OCTOBER 21, 2024
Sponsored by: Assemblywoman SHANIQUE SPEIGHT District 29 (Essex and Hudson) Assemblyman HERB CONAWAY, JR. District 7 (Burlington) Assemblywoman MARGIE DONLON, M.D. District 11 (Monmouth) SYNOPSIS Requires health insurers, SHBP, SEHBP, and NJ FamilyCare coverage for sign language interpreter services for covered individuals who are deaf or hard of hearing. CURRENT VERSION OF TEXT As introduced.
Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
Assemblywoman MARGIE DONLON, M.D.
District 11 (Monmouth)
SYNOPSIS
Requires health insurers, SHBP, SEHBP, and NJ FamilyCare coverage for sign language interpreter services for covered individuals who are deaf or hard of hearing.
CURRENT VERSION OF TEXT
As introduced.
An Act requiring health benefits coverage for interpreter services for certain individuals 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, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. f. This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium. 2. a. A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. f. This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium. 3. a. A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. f. This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium. 4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the policy. f. This section shall apply to those policies in which the insurer has reserved the right to change the premium. 5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the policy. f. This section shall apply to those policies in which the insurer has reserved the right to change the premium. 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the plan. f. This section shall apply to those plans in which the carrier has reserved the right to change the premium. 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the plan. f. This section shall apply to those plans in which the carrier has reserved the right to change the premium. 8. a. A health maintenance organization contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. f. This section shall apply to those contracts for health care services in which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage. 9. a. The State Health Benefits Commission shall ensure that every contract purchased on or after the effective date of this act, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.53 per hour. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. 10. a. The School Employees' Health Benefits Commission shall ensure that every contract purchased on or after the effective date of this act, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.53 per hour. b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. As used in this section: "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract. 11. a. The NJ FamilyCare program shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.40 per hour. b. Coverage shall be provided, upon the request of an enrollee who is deaf or hard of hearing, as follows: (1) the services of a qualified sign language interpreter; or (2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available. c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the enrollee who is deaf or hard of hearing, unless the following conditions have been satisfied: (1) the family member or friend is a qualified sign language interpreter; and (2) the enrollee who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or (3) the enrollee who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter. (4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing. (5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child. d. The Commissioner of Human Services shall apply for such federal waivers or state plan amendments as are necessary to implement the provisions of this section and to continue to secure federal financial participation for State expenditures under the federal Medicaid program and the Children's Health Insurance Program. e. Coverage of, and the reimbursement rate established for, sign language interpreter services under the NJ FamilyCare program, pursuant to this section, is contingent upon federal approval of the State's application for a waiver or a state plan amendment under Title XIX of the Social Security Act (42 5 U.S.C. s.1315 et seq.). f. As used in this section: "Commissioner" means the Commissioner of Human Services. "Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology. "Enrollee" means an individual who is covered under the Medicaid program or the NJ FamilyCare program. "Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing. "NJ FamilyCare" means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which includes the State's Medicaid Program and the Children's Health Insurance Program. "Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. "Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices. 12. The State Treasurer and the Commissioners of Banking and Insurance and Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to implement the provisions of this act. 13. This act shall take effect on the first day of the fourth month next following the date of enactment, except that the State Treasurer and the Commissioners of Banking and Insurance and Human Services may take any anticipatory administrative action in advance thereof as may be necessary for the implementation of this act. STATEMENT This bill requires private health insurance plans, the State Health Benefits Program (SHBP), the School Employees Health Benefits Program (SEHBP), and the NJ FamilyCare program to cover the services of a qualified sign language interpreter during a medical encounter for an individual who is deaf or hard of hearing. A "qualified sign language interpreter" is defined as an interpreter, preferably with expertise in medical interpreting, who is certified by the New Jersey Registry of Interpreters for the Deaf or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services. The bill also establishes a minimum reimbursement rate of $42.40 per hour for sign language interpreter services provided during a medical encounter for NJ FamilyCare enrollees, and $42.53 when such services are provided for an individual covered under the SHBP or the SEHBP. Under the bill, sign language interpreter services would be provided upon the request of a patient who is deaf or hard of hearing. Video remote interpreter services also would be covered, provided in person interpreter services are not available. The bill stipulates that interpreter services will not be covered in situations in which such services are provided by a family member or friend of the requester, unless: 1. the family member or friend is a qualified sign language interpreter; and 2. the individual requesting sign language interpreter services consents to having the family member or friend interpret during the medical encounter; or 3. the individual who is deaf or hard of hearing is a minor, and the child's parent or legal guardian is present and agrees to interpret during the medical encounter. In cases of suspected domestic violence, a health care provider is prohibited from allowing a family member to serve as a sign language interpreter during a health care encounter for an individual who is deaf or hard of hearing; rather, the bill requires the health care provider to provide a qualified sign language interpreter or video remote interpreter services during the encounter. In cases of suspected child abuse or neglect by a parent or legal guardian, the health care provider may not permit the parent or guardian to serve as a sign language interpreter for a minor child who is deaf or hard of hearing. The bill instead requires the health care provider to provide a qualified sign language interpreter for the child during the encounter. NJ FamilyCare coverage of, and the reimbursement rate for, interpreter services will be contingent upon federal approval of the State's application for any requisite Medicaid or CHIP waivers or state plan amendments. The Americans with Disabilities Act (ADA), Pub.L.101-336 (42 U.S.C., s. 12101 et seq.) and federal regulations grant individuals who are deaf or hard of hearing the legal right to equal access to, and an equal opportunity to participate in and benefit from, health care. Federal regulations permit the use of sign language interpreters as one of the acceptable "auxiliary aids and services" that medical providers are required to furnish to ensure accessible and effective communication with patients who are deaf or hard of hearing. Federal regulations prohibit medical providers from billing patients for the provision of sign language interpretation; rather, medical providers are advised to treat expenditures on interpreter services as an administrative or an overhead cost of their practice. The ADA provides a limited exemption for medical providers who demonstrate that furnishing a specific auxiliary aid or service, as requested by a patient with a disability, would present an undue burden or cause a fundamental change in the nature of the provider's services and goods. In such instances, however, the ADA stipulates that the medical provider must furnish an alternative auxiliary aid or service that would not present an undue burden and would facilitate effective provider-patient communications. It is the sponsor's intent to codify existing federal requirements concerning sign language interpreter services to ensure that private health insurance plans, the SHBP, the SEHBP, and the NJ FamilyCare program, cover sign language interpreter services during medical encounters for enrollees who are deaf or hard of hearing.
An Act requiring health benefits coverage for interpreter services for certain individuals 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, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
f. This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
2. a. A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
f. This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
3. a. A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
f. This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.
4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the policy.
f. This section shall apply to those policies in which the insurer has reserved the right to change the premium.
5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the policy.
f. This section shall apply to those policies in which the insurer has reserved the right to change the premium.
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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the plan.
f. This section shall apply to those plans in which the carrier has reserved the right to change the premium.
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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the plan.
f. This section shall apply to those plans in which the carrier has reserved the right to change the premium.
8. a. A health maintenance organization contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State, 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, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
f. This section shall apply to those contracts for health care services in which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
9. a. The State Health Benefits Commission shall ensure that every contract purchased on or after the effective date of this act, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.53 per hour.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
10. a. The School Employees' Health Benefits Commission shall ensure that every contract purchased on or after the effective date of this act, shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.53 per hour.
b. Coverage shall be provided, upon the request of an individual who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the individual who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the individual who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the individual who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. As used in this section:
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
e. The benefits required by this section shall be provided to the same extent as for any other condition under the contract.
11. a. The NJ FamilyCare program shall provide coverage for expenses incurred for the services of a qualified sign language interpreter during a health care encounter, at a reimbursement rate of no less than $42.40 per hour.
b. Coverage shall be provided, upon the request of an enrollee who is deaf or hard of hearing, as follows:
(1) the services of a qualified sign language interpreter; or
(2) video remote interpreter services in situations in which the in-person services of a qualified sign language interpreter are not available.
c. Coverage shall not be provided for the services of a sign language interpreter who is a family member or friend of the enrollee who is deaf or hard of hearing, unless the following conditions have been satisfied:
(1) the family member or friend is a qualified sign language interpreter; and
(2) the enrollee who is deaf or hard of hearing has consented to having the family member or friend serve as a sign language interpreter during the health care encounter; or
(3) the enrollee who is deaf or hard of hearing is a minor child, and the parent or legal guardian of the minor child is present and agrees to provide sign language interpretation services for the minor child, as necessary, during the health care encounter.
(4) In a case of suspected domestic violence, a health care provider shall not permit a family member to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter or video remote interpreter services for an individual who is deaf or hard of hearing.
(5) In a case in which one or both parents or a legal guardian is suspected of child abuse or neglect of a minor child who is deaf or hard of hearing, the health care provider shall not permit the parent or legal guardian to serve as a sign language interpreter during the health care encounter, and shall instead provide a qualified sign language interpreter for the minor child.
d. The Commissioner of Human Services shall apply for such federal waivers or state plan amendments as are necessary to implement the provisions of this section and to continue to secure federal financial participation for State expenditures under the federal Medicaid program and the Children's Health Insurance Program.
e. Coverage of, and the reimbursement rate established for, sign language interpreter services under the NJ FamilyCare program, pursuant to this section, is contingent upon federal approval of the State's application for a waiver or a state plan amendment under Title XIX of the Social Security Act (42 5 U.S.C. s.1315 et seq.).
f. As used in this section:
"Commissioner" means the Commissioner of Human Services.
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology.
"Enrollee" means an individual who is covered under the Medicaid program or the NJ FamilyCare program.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"NJ FamilyCare" means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which includes the State's Medicaid Program and the Children's Health Insurance Program.
"Qualified sign language interpreter" means a sign language interpreter, preferably with expertise in a medical setting, who is certified by the New Jersey Registry of Interpreters for the Deaf, or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Video remote interpreting services" means remote sign language interpretation using real-time, full motion video and audio over a dedicated high-speed, wide-bandwidth video connection or a wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication, and that are large enough to display both the interpreter's and the participant's face, arms, hands, and fingers. The audio component of the service should provide a clear, audible transmission of voices.
12. The State Treasurer and the Commissioners of Banking and Insurance and Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to implement the provisions of this act.
13. This act shall take effect on the first day of the fourth month next following the date of enactment, except that the State Treasurer and the Commissioners of Banking and Insurance and Human Services may take any anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.
STATEMENT
This bill requires private health insurance plans, the State Health Benefits Program (SHBP), the School Employees Health Benefits Program (SEHBP), and the NJ FamilyCare program to cover the services of a qualified sign language interpreter during a medical encounter for an individual who is deaf or hard of hearing. A "qualified sign language interpreter" is defined as an interpreter, preferably with expertise in medical interpreting, who is certified by the New Jersey Registry of Interpreters for the Deaf or by an accredited certifying organization designated by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
The bill also establishes a minimum reimbursement rate of $42.40 per hour for sign language interpreter services provided during a medical encounter for NJ FamilyCare enrollees, and $42.53 when such services are provided for an individual covered under the SHBP or the SEHBP.
Under the bill, sign language interpreter services would be provided upon the request of a patient who is deaf or hard of hearing. Video remote interpreter services also would be covered, provided in person interpreter services are not available.
The bill stipulates that interpreter services will not be covered in situations in which such services are provided by a family member or friend of the requester, unless:
1. the family member or friend is a qualified sign language interpreter; and
2. the individual requesting sign language interpreter services consents to having the family member or friend interpret during the medical encounter; or
3. the individual who is deaf or hard of hearing is a minor, and the child's parent or legal guardian is present and agrees to interpret during the medical encounter.
In cases of suspected domestic violence, a health care provider is prohibited from allowing a family member to serve as a sign language interpreter during a health care encounter for an individual who is deaf or hard of hearing; rather, the bill requires the health care provider to provide a qualified sign language interpreter or video remote interpreter services during the encounter. In cases of suspected child abuse or neglect by a parent or legal guardian, the health care provider may not permit the parent or guardian to serve as a sign language interpreter for a minor child who is deaf or hard of hearing. The bill instead requires the health care provider to provide a qualified sign language interpreter for the child during the encounter.
NJ FamilyCare coverage of, and the reimbursement rate for, interpreter services will be contingent upon federal approval of the State's application for any requisite Medicaid or CHIP waivers or state plan amendments.
The Americans with Disabilities Act (ADA), Pub.L.101-336 (42 U.S.C., s. 12101 et seq.) and federal regulations grant individuals who are deaf or hard of hearing the legal right to equal access to, and an equal opportunity to participate in and benefit from, health care. Federal regulations permit the use of sign language interpreters as one of the acceptable "auxiliary aids and services" that medical providers are required to furnish to ensure accessible and effective communication with patients who are deaf or hard of hearing.
Federal regulations prohibit medical providers from billing patients for the provision of sign language interpretation; rather, medical providers are advised to treat expenditures on interpreter services as an administrative or an overhead cost of their practice.
The ADA provides a limited exemption for medical providers who demonstrate that furnishing a specific auxiliary aid or service, as requested by a patient with a disability, would present an undue burden or cause a fundamental change in the nature of the provider's services and goods. In such instances, however, the ADA stipulates that the medical provider must furnish an alternative auxiliary aid or service that would not present an undue burden and would facilitate effective provider-patient communications.
It is the sponsor's intent to codify existing federal requirements concerning sign language interpreter services to ensure that private health insurance plans, the SHBP, the SEHBP, and the NJ FamilyCare program, cover sign language interpreter services during medical encounters for enrollees who are deaf or hard of hearing.