reglab/housing_qa huggingface dataset:
NJ Rev Stat § 17B:26-2.1m (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1m - Coverage for minimum inpatient care following mastectomy by individual hospital, medical expense benefits policy

17B:26-2.1m. Coverage for minimum inpatient care following mastectomy by individual hospital, medical expense benefits policy  4. a. Every individual policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act shall provide coverage for a minimum of 72 hours of inpatient care following a modified radical mastectomy and a minimum of 48 hours of inpatient care following a simple mastectomy. The policy shall not require a health care provider to obtain authorization from the insurer for prescribing 72 or 48 hours, as appropriate, of inpatient care as provided for in this section. The provisions of this section shall not be construed to: require a patient to receive inpatient care for 72 or 48 hours, as appropriate, if the patient in consultation with the patient's physician determines that a shorter length of stay is medically appropriate; or relieve a patient or a patient's physician, if appropriate, of any notification requirements to the insurer under the policy. The benefits shall be provided to the same extent as for any other sickness under the policy. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. b. The Commissioner of Banking and Insurance shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to implement the provisions of this section. L.1997,c.149,s.4.
NJ Rev Stat § 17B:26-2.1n (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1n - Applicability of Health Care Quality Act

17B:26-2.1n Applicability of Health Care Quality Act  21. Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed or renewed on or after the effective date of this act unless the policy meets the requirements of P.L.1997, c.192 (C.26:2S-1 et al.) and regulations adopted thereto. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. L.1997,c.192,s.21.
NJ Rev Stat § 17B:26-2.1o (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1o - Coverage for treatment of inherited metabolic diseases by individual health insurance policy.

17B:26-2.1o Coverage for treatment of inherited metabolic diseases by individual health insurance policy.  4. No individual health insurance policy providing hospital or medical expense benefits shall be 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, unless the policy provides benefits to each person covered thereunder for expenses incurred in the therapeutic treatment of inherited metabolic diseases, including the purchase of medical foods and low protein modified food products, when diagnosed and determined to be medically necessary by the covered person's physician. For the purposes of this section, "inherited metabolic disease" means a disease caused by an inherited abnormality of body chemistry for which testing is mandated pursuant to P.L.1977, c.321 (C.26:2-110 et seq.); "low protein modified food product" means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a physician for the dietary treatment of an inherited metabolic disease, but does not include a natural food that is naturally low in protein; and "medical food" means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered enterally under direction of a physician. The benefits shall be provided to the same extent as for any other medical condition under the policy. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. L.1997,c.338,s.4.
NJ Rev Stat § 17B:26-2.1p (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1p - Health insurance policy to cover certain audiology, speech-language pathology services.

17B:26-2.1p Health insurance policy to cover certain audiology, speech-language pathology services.  4. Notwithstanding any other provision of chapter 26 of Title 17B of the New Jersey Statutes, benefits shall not be denied to any eligible individual for eligible services, as determined by the terms of the policy or as otherwise required by law, when the services are determined by a physician to be medically necessary and are performed or rendered to that individual by a licensed audiologist or speech-language pathologist within the scope of practice. The practices of audiology and speech-language pathology shall be deemed to be within the provisions of chapter 26 of Title 17B of the New Jersey Statutes and duly licensed audiologists and speech-language pathologists shall have such privileges and benefits in the scope of their practice under that act as are afforded thereunder to licensed physicians and surgeons in the scope of their practice. L.1997,c.419,s.4.
NJ Rev Stat § 17B:26-2.1q (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1q - Coverage for treatment of domestic violence injuries by individual health insurance policy.

17B:26-2.1q Coverage for treatment of domestic violence injuries by individual health insurance policy.  4. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.), no individual health insurance policy providing hospital or medical expense benefits shall contain any provision which denies benefits for expenses incurred in the treatment of an injury or injuries sustained as the result of domestic violence as defined in section 3 of P.L.1991, c.261 (C.2C:25-19), to a named insured or other person covered thereunder. Benefits shall be provided to the same extent as for any other treatment under the policy. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. L.1998,c.97,s.4.
NJ Rev Stat § 17B:26-2.1r (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1r - Coverage for certain dental procedures for the severely disabled or child age five or under by individual health insurance policy

17B:26-2.1r. Coverage for certain dental procedures for the severely disabled or child age five or under by individual health insurance policy  4. a. No individual health insurance policy providing hospital or medical benefits shall be delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this amendatory and supplementary act, unless the policy provides benefits to any person covered thereunder who is severely disabled or a child age five or under for expenses incurred for: (1) general anesthesia and hospitalization for dental services; or (2) a medical condition covered by the contract which requires hospitalization or general anesthesia for dental services rendered by a dentist regardless of where the dental services are provided. b. An individual health insurance policy may require prior authorization of hospitalization for dental services in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions. c. This section shall apply to all individual health insurance policies in which the insurer has reserved the right to change the premium. L.1999,c.49,s.4.
NJ Rev Stat § 17B:26-2.1s (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1s - Individual health insurers to provide coverage for mental health conditions and substance use disorders.

17B:26-2.1s Individual health insurers to provide coverage for mental health conditions and substance use disorders.  4. a. (1) Every individual health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, 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 mental health conditions and substance use disorders under the same terms and conditions as provided for any other sickness under the contract and shall meet the requirements of the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. s.18031(j), and any amendments to, and federal guidance or regulations issued under that act, including 45 C.F.R. Parts 146 and 147 and 45 C.F.R. s.156.115(a)(3).  (2) As used in this section: "Mental health condition" means a condition defined to be consistent with generally recognized independent standards of current medical practice referenced in the current version of the Diagnostic and Statistical Manual of Mental Disorders. "Same terms and conditions" means that the insurer cannot apply more restrictive non-quantitative limitations, such as utilization review and other criteria or more quantitative limitations such as copayments, deductibles, aggregate or annual limits or benefit limits to mental health condition and substance use disorder benefits than those applied to substantially all other medical or surgical benefits.  "Substance use disorder" means a disorder defined to be consistent with generally recognized independent standards of current medical practice referenced in the most current version of the Diagnostic and Statistical Manual of Mental Disorders. b. (Deleted by amendment, P.L.2019, c.58) c. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. d. Nothing in this section shall reduce the requirement for an insurer to provide benefits pursuant to section 4 of P.L.2017, c.28 (C.17B:26-2.1hh). L.1999, c.106, s.4; amended 2019, c.58, s.4.
NJ Rev Stat § 17B:26-2.1t (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1t - Coverage for hemophilia services by individual health insurers

17B:26-2.1t. Coverage for hemophilia services by individual health insurers  3. Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed or renewed on or after the effective date of P.L.2000, c.121 (C.26:2S-10.1 et al.) unless the policy meets the requirements of sections 1 and 2 of P.L.2000, c.121 (C.26:2S-10.1 and C.26:2S-10.2) and the regulations adopted thereto. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. L.2000,c.121,s.3.
NJ Rev Stat § 17B:26-2.1u (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1u - Individual policy to provide coverage for colorectal cancer screening.

17B:26-2.1u Individual policy to provide coverage for colorectal cancer screening.  4. Every individual policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named insured or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age 50 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person. As used in this section, "high risk for colorectal cancer" means a person has: a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps; b. chronic inflammatory bowel disease; or c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer. The benefits shall be provided to the same extent as for any other medical condition under the policy. The provisions of this section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium. L.2001,c.295,s.4.
NJ Rev Stat § 17B:26-2.1v (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1v - Individual health insurer prescription drug plans to cover certain infant formulas.

17B:26-2.1v Individual health insurer prescription drug plans to cover certain infant formulas.  5. An individual health insurer which provides hospital or medical expense benefits for expenses incurred in the purchase of prescription drugs under a policy that 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 benefits under the policy for expenses incurred in the purchase of specialized non-standard infant formulas, when the covered infant's physician has diagnosed the infant as having multiple food protein intolerance and has determined such formula to be medically necessary, and when the covered infant has not been responsive to trials of standard non-cow milk-based formulas, including soybean and goat milk. The coverage may be subject to utilization review, including periodic review, of the continued medical necessity of the specialized infant formula. The benefits shall be provided to the same extent as for any other prescribed items under the policy. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2001,c.361,s.5.
NJ Rev Stat § 17B:26-2.1w (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1w - Policy issued under Chapter 26 of Title 17B required to cover certain out-of-network services.

17B:26-2.1w Policy issued under Chapter 26 of Title 17B required to cover certain out-of-network services.  3. Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed or renewed on or after the effective date of this act unless the policy meets the requirements of P.L.2001, c.367 (C.26:2S-6.1 et al.). The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium. L.2001,c.367,s.3.
NJ Rev Stat § 17B:26-2.1x (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1x - Individual health insurer to offer coverage for domestic partner.

17B:26-2.1x Individual health insurer to offer coverage for domestic partner.  50. An individual health insurer that provides hospital or medical expense benefits under a policy that 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 P.L.2003, c.246 (C.26:8A-1 et al.), under which dependent coverage is available, shall offer dependent coverage to a covered person for a covered person's domestic partner. For the purposes of this section, "domestic partner" means a domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3). This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2003,c.246,s.50.
NJ Rev Stat § 17B:26-2.1z (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1z - Individual health insurance policies to provide benefits for orthotic and prosthetic appliances.

17B:26-2.1z Individual health insurance policies to provide benefits for orthotic and prosthetic appliances.  4. a. Every individual health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in obtaining an orthotic or prosthetic appliance from any licensed orthotist or prosthetist, or any certified pedorthist, as determined medically necessary by the covered person's physician. As used in this section, "orthotic appliance," "prosthetic appliance," "licensed orthotist" and "licensed prosthetist" have the meaning assigned to them in section 3 of P.L.1991, c.512 (C.45:12B-3) and "certified pedorthist" has the meaning assigned to it in subsection j. of section 18 of P.L.1991, c.512 (C.45:12B-18). b. On and after the effective date of this act, an individual health insurance policy shall reimburse for orthotic and prosthetic appliances at the same rate as reimbursement for such appliances under the federal Medicare reimbursement schedule. c. The benefits shall be provided to the same extent as for any other medical condition under the policy. d. The provisions of this section shall apply to all individual health insurance policies in which the insurer has reserved the right to change the premium. L.2007, c.345, s.4.
NJ Rev Stat § 17B:26-2.1aa (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1aa - Individual health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.

17B:26-2.1aa Individual health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.  5. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes, 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 medically necessary expenses incurred in the purchase of a hearing aid for a covered person 15 years of age or younger, as provided in this section. A policy shall provide coverage that includes the purchase of a hearing aid for each ear, when medically necessary and as prescribed or recommended by a licensed physician or audiologist. An insurer may limit the benefit provided in this section to $1,000 per hearing aid for each hearing-impaired ear every 24 months. A covered person may choose a hearing aid that is priced higher than the benefit payable under this section and may pay the difference between the price of the hearing aid and the benefit payable under this section, without financial or contractual penalty to the provider of the hearing aid. The benefits shall be provided to the same extent as for any other condition under the policy. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2008, c.126, s.5.
NJ Rev Stat § 17B:26-2.1bb (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1bb - Individual health insurance policy to provide installment payments to obstetrical provider for maternity services.

17B:26-2.1bb Individual health insurance policy to provide installment payments to obstetrical provider for maternity services.  4. a. Every individual health insurance policy that provides benefits for maternity services, and that 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 for reimbursement in installments to an obstetrical provider licensed in New Jersey for maternity services rendered during the term of a covered person's pregnancy.  b. For the purposes of this section, "obstetrical provider licensed in New Jersey" means:  (1) an obstetrician/gynecologist licensed by the State Board of Medical Examiners; or  (2) a midwife licensed by the State Board of Medical Examiners as a certified midwife or a certified nurse midwife. c. This section shall apply to all individual health insurance policies in which the insurer has reserved the right to change the premium. L.2009, c.113, s.4.
NJ Rev Stat § 17B:26-2.1dd (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:26-2.1dd - Individual health insurance policy to provide coverage for oral anticancer medications.

17B:26-2.1dd Individual health insurance policy to provide coverage for oral anticancer medications.  4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells on a basis no less favorable than the policy provides for intravenously administered or injected anticancer medications.  b. Pursuant to subsection a. of this section, coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medications. c. An individual health insurance policy shall not achieve compliance with the provisions of this section by imposing an increase in patient cost sharing, including any copayment, deductible or coinsurance, for anticancer medications, whether intravenously administered or injected or orally administered, that are covered under the policy as of the effective date of this act. d. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2011, c.188, s.4.