reglab/statecodes huggingface dataset:
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-30 - Definitions regarding dental plan application forms

26:2S-30. Definitions regarding dental plan application forms
1. As used in this act:
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, dental service corporation, dental plan organization, or health maintenance organization, authorized to issue or act as an administrator of dental plans in this State.
"Dental plan" means a benefits plan which pays or provides dental expense benefits for covered services and is delivered or issued for delivery in this State by or through a carrier either on a stand-alone basis or as part of other coverage including, but not limited to, health benefits coverage.
L.2019, c.3, s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-31 - Adoption of dental plan application forms

26:2S-31. Adoption of dental plan application forms
2. a. The Commissioner of Banking and Insurance shall adopt by regulation a universal dentist application for participation form for use by carriers which offer or administer dental plans for the purpose of credentialing dentists who seek to participate in a carrier's provider network and for the purpose of credentialing dentists who are employed by hospitals or other health care facilities which seek to participate in a carrier's provider network.
b. The commissioner shall also adopt by regulation a form for renewal of credentialing, which shall be an abbreviated version of the universal application form. The renewal form shall be designed to enable a dentist to indicate changes in the information provided in the application form.
c. The commissioner shall revise the universal application and renewal forms, as necessary, to conform to industry-wide, national standards for credentialing.
d. In developing the forms, the commissioner shall consult with the Commissioner of Human Services to ensure that the credentialing requirements for participation in the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.) are adequately reflected on the application and renewal forms.
L.2019, c.3, s.2.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-32 - Acceptance of universal dentist application

26:2S-32. Acceptance of universal dentist application
3. a. Within 180 days of the adoption of the forms by regulation pursuant to this act, a carrier which offers or administers a dental plan shall accept the universal dentist application for participation form and renewal form adopted pursuant to this act for the purpose of credentialing dentists who seek to participate in the carrier's provider network and for the purpose of credentialing dentists who are employed by hospitals or other health care facilities which seek to participate in the carrier's provider network.
b. Nothing in this section shall be construed to prevent a carrier from requesting additional information from an applicant that is not provided for in the universal application or renewal form, as applicable, if the requested information does not duplicate any information included in the applicable form.
L.2019, c.3, s.3.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-33 - Adoption of regulations

26:2S-33. Adoption of regulations
4. The Commissioner of Banking and Insurance shall adopt regulations within 180 days of the date of enactment of this act, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this act.
L.2019, c.3, s.4.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-34 - Preexisting condition provision prohibited in health benefits plan.

26:2S-34 Preexisting condition provision prohibited in health benefits plan.
6. A carrier that offers a health benefits plan in this State shall ensure that the plan does not contain any provision that:
a. denies or limits benefits for a preexisting condition to any covered person; or
b. uses a preexisting condition as a factor in calculating a premium.
L.2019, c.253, s.6.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-35 - Imposition of limits prohibited.

26:2S-35 Imposition of limits prohibited.
4. Notwithstanding any law to the contrary, a health benefits plan shall not impose:
(1) any lifetime limits on the dollar value of benefits for any individual insured pursuant to the plan; or
(2) any annual limits on the dollar value of essential health benefits.
L.2019, c.354, s.4.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-36 - Provision of emergency, urgent services.

26:2S-36 Provision of emergency, urgent services.
5. A carrier that offers a health benefits plan in this State shall provide that coverage for medically necessary services on an emergency or urgent basis shall be provided without imposing any requirement under the plan for prior authorization of the services or, if the services are provided by an out-of-network provider, any limitation on coverage that is more restrictive than if the services were provided by an in-network provider.
L.2019, c.354, s.5.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-37 - Insurance plans to cover prescription refills during state of emergency.

26:2S-37 Insurance plans to cover prescription refills during state of emergency.
2. a. Subject to subsection b. of this section and to the extent consistent with clinical guidelines, the Commissioner of Banking and Insurance shall require carriers to provide coverage of prescription drug refills even when the covered person has not yet reached the scheduled refill date, provided that the prescription itself would remain valid beyond the refill date and the member will be eligible beyond the refill date, in a manner calculated to ensure a subscriber's ability to maintain at least a 30-day supply, or a 90-day supply of a maintenance medication supply at home but not to exceed a 120-day supply on-hand at any given time. The coverage shall be provided based on the authorization for the most recently filled prescription and additional authorization for the refill shall not be required.
b. The provisions of this section shall be in effect if:
(1) a state of emergency or public health emergency is declared by the State or federal government, or an emergency supply of a drug is recommended by the Centers for Disease Control and Prevention; and
(2) the commissioner determines that an emergency supply of prescription drugs is necessary.
c. The coverage shall be provided on an in-network basis to the same extent as for any other refills of prescription drugs under the health benefits plan, except that:
(1) in the event of a drug shortage or access issue identified by the commissioner or the Division of Consumer Affairs, the carrier shall provide formulary flexibility for a covered alternative. The cost-sharing for any non-preferred medication shall not exceed the cost-sharing that would be imposed for the preferred medication that is unavailable due to the shortage or access issue; and
(2) no fees shall be imposed for home delivery of the drugs.
d. The Division of Consumer Affairs, in consultation with the commissioner, may develop restrictions on the filling or refilling of prescriptions by pharmacists to address shortage concerns, provided those restrictions shall exclude restricting use for existing conditions to the maximum extent practicable.
e. As used in this section, "carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, and shall include the State Health Benefits Program and the School Employees' Health Benefits Program.
L.2020, c.30, s.2.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-38 - Prescription drug benefit carrier contracts, opioid antidote coverage.

26:2S-38 Prescription drug benefit carrier contracts, opioid antidote coverage.
1. a. A carrier shall ensure that every contract to provide prescription drug benefits, or to authorize the purchase of a contract to provide prescription drug benefits, shall provide coverage for an opioid antidote to covered persons without the imposition of any prior authorization or other utilization management requirements, provided that the drug is:
(1) prescribed or administered to the covered person by a licensed medical practitioner who is authorized to prescribe or administer that treatment pursuant to State and federal law; or
(2) dispensed to the covered person by a licensed pharmacist under a standing order to dispense an opioid antidote pursuant to section 1 of P.L.2017, c.88 (C.45:14-67.2).
b. The provisions of this section shall not be construed to limit the coverage of an opioid antidote only when administered by a medical practitioner.
c. As used in this section:
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.
"Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for self-administration for the treatment of an opioid overdose.
L.2021, c.157, s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-39 - Health benefit plans, coverage for abortion, certain religious employers exempt.

26:2S-39 Health benefit plans, coverage for abortion, certain religious employers exempt.
3. a. Upon concluding a study and issuing a report to the Governor and the Legislature demonstrating that such a regulation is necessary, the Department of Banking and Insurance may, through regulation adopted pursuant to the "Administrative Procedure Act", P.L.1968 c.410 (C.52:14B-1 et seq.), provide that health benefit plans delivered, issued, executed, or renewed in this State, provide coverage for abortion. If the department provides for coverage pursuant to this section, then the department shall also require carriers to grant, upon request of a religious employer, an exclusion under the contract for the coverage required if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to covered persons and prospective covered persons, and the carrier shall provide notice to the Commissioner of Banking and Insurance in such form and manner as may be determined by the commissioner. The provisions of this paragraph shall not be construed as authorizing a carrier to exclude coverage for care that is necessary to preserve the life or health of a subscriber. An exclusion from an insurance coverage mandate granted to a religious employer pursuant to this section shall not be considered a violation of section 2 of P.L.2021, c.375 (C.10:7-2).
b. For the purposes of this section, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
L.2021, c.375, s.3.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2S-40 - Carrier to ensure provision of comprehensive behavioral health crisis intervention services coverage.

26:2S-40 Carrier to ensure provision of comprehensive behavioral health crisis intervention services coverage.
8. A carrier that offers a health benefits plan in this State shall ensure that the plan provides comprehensive coverage for behavioral health crisis intervention services provided pursuant to section 3 of P.L.2022, c.35 (C.26:2MM7) under the same terms and conditions as provided for any other sickness under the plan 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).
L.2022, c.35, s.8.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-2 - Findings, declarations relative to out-of-network health care charges.

26:2SS-2 Findings, declarations relative to out-of-network health care charges.
2. The Legislature finds and declares that:
a. The health care delivery system in New Jersey needs reforms that will enhance consumer protections, create a system to resolve certain health care billing disputes, contain rising costs, and measure success with respect to these goals;
b. Despite existing State and federal laws and regulations to protect against certain surprise out-of-network charges, these charges continue to pose a problem for health care consumers in New Jersey. Many consumers find themselves with surprise bills for hospital emergency room procedures or for charges by providers that the consumer had no choice in selecting;
c. While the Patient Protection and Affordable Care Act added new patient protections requiring federally-regulated group health plans to reimburse for out-of-network emergency service by paying the greatest of three possible amounts: (1) the amount negotiated with in-network providers for the emergency service furnished; (2) the amount for the emergency service calculated using the same method the plan generally uses to determine payments for out-of-network services; or (3) the amount that would be paid under Medicare for the emergency service, patients continue to face out-of-network charges for surprise bills;
d. Out-of-network benefits are a health insurance benefit enhancement for which insureds pay an additional premium, but in recent years, out-of-network coverage has been used inappropriately as a means to diminish consumers' health insurance coverage, exposing consumers to additional costs;
e. Carriers and consumers continue to report exorbitant charges by certain health care professionals and facilities for out-of-network services, including balance billing, and in certain cases, consumers' bills are referred to collection, which contributes to the increasing costs of health care services and insurance and imposes hardships on health care consumers;
f. Health care providers and hospitals report that inadequate reimbursement from carriers and government payers is causing financial stress on safety net hospitals, deteriorating morale among providers and reduced quality of care for consumers;
g. It is, therefore, in the public interest to reform the health care delivery system in New Jersey to enhance consumer protections, create a system to resolve certain health care billing disputes, contain rising costs, and measure success with respect to these goals.
L.2018, c.32, s.2.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-7 - Billing for emergency, urgent care.

26:2SS-7 Billing for emergency, urgent care.
7. a. If a covered person receives medically necessary services at any health care facility on an emergency or urgent basis as defined by the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. s.1395dd et seq. and section 14 of P.L.1992, c.160 (C.26:2H-18.64), the facility shall not bill the covered person in excess of any deductible, copayment, or coinsurance amount applicable to in-network services pursuant to the covered person's health benefits plan.
b. If a covered person receives medically necessary services at an out-of-network health care facility on an emergency or urgent basis as defined by the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. s.1395dd et seq. and section 14 of P.L.1992, c.160 (C.26:2H-18.64), and the carrier and facility cannot agree on the final offer as a reimbursement rate for these services pursuant to section 9 of this act, the carrier, health care facility, or covered person, as applicable, may initiate binding arbitration pursuant to section 10 or 11 of this act.
c. If a health care facility is in-network with respect to any health benefits plan, the facility shall ensure that all providers providing services in the facility on an emergency or inadvertent basis are provided notification of the provisions of this act and information as to each health benefits plan with which the facility has a contract to be in-network.
d. A health care facility that contracts with a carrier to be in-network with respect to any health benefits plan shall annually report to the Department of Health the health benefits plans with which the facility has an agreement to be in-network.
e. Subsections a. and b. of this section shall only apply to providers providing services to members of entities providing or administering a self-funded health benefits plan and its plan members if the entity elects to be subject to section 9 of this act pursuant to subsection d. of that section.
f. The Department of Health shall make the information collected pursuant to subsection d. of this section available to the Department of Banking and Insurance.
L.2018, c.32, s.7.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-8 - Coverage for inadvertent out-of-network emergency services.

26:2SS-8 Coverage for inadvertent out-of-network emergency services.
8. a. If a covered person receives inadvertent out-of-network services or medically necessary services at an in-network or out-of-network health care facility on an emergency or urgent basis as defined by the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. s.1395dd et seq. and section 14 of P.L.1992, c.160 (C.26:2H-18.64), the health care professional performing those services shall:
(1) in the case of inadvertent out-of-network services, not bill the covered person in excess of any deductible, copayment, or coinsurance amount; and
(2) in the case of emergency and urgent services, not bill the covered person in excess of any deductible, copayment, or coinsurance amount, applicable to in-network services pursuant to the covered person's health benefits plan.
b. If the carrier and the professional cannot agree on a reimbursement rate for the services provided pursuant to subsection a. of this section, pursuant to section 9 of this act the carrier, professional, or covered person, as applicable, may initiate binding arbitration pursuant to section 10 or 11 of this act.
c. This section shall only apply to providers providing services to members of entities providing or administering a self-funded health benefits plan and its plan members if the entity elects to be subject to section 9 of this act pursuant to subsection d. of that section.
L.2018, c.32, s.8.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-11 - Payment disputes for member of self-funded plan, binding arbitration.

26:2SS-11 Payment disputes for member of self-funded plan, binding arbitration.
11. a. If attempts to negotiate reimbursement for services between an out-of-network health care provider and a member of a self-funded plan that does not elect to be subject to the provisions of section 9 of this act do not result in a resolution of the payment dispute within 30 days after the plan member is sent a bill for the services, the plan member or out-of-network health care provider may initiate binding arbitration to determine payment for the services. Unless negotiations for reimbursement result in an agreement between the provider and the plan member within the 30 days, a provider shall not collect or attempt to collect reimbursement, including initiation of any collection proceedings, until the provider files a request for arbitration with the department pursuant to this section.
b. The binding arbitration shall adhere to the following requirements:
(1) Arbitration shall be initiated by filing a request with the department. The department shall establish a process to notify the other party that arbitration has been initiated and to inform a plan member of the process to arbitrate pursuant to this section;
(2) The arbitrator with which the department contracts pursuant to section 10 of this act shall conduct the arbitration pursuant to this section;
(3) The arbitrator shall consider information supplied by both parties; and
(4) The arbitrator's decision shall include written findings, including a final binding amount that the arbitrator determines is reasonable for the service, which shall include a non-binding recommendation to the entity providing or administering the self-funded health benefits plan of an amount that would be reasonable for the entity to contribute to payment for the service, and shall be issued within 30 days after the request is filed with the department.
c. The arbitrator's expenses and fees shall be divided equally among the parties, unless the payment would pose a financial hardship to the plan member, in which case the department shall establish an agreement with the arbitrator to waive any part or all of the cost of arbitration. Each party shall be responsible for its own costs and fees, including legal fees, if any.
d. This section shall not apply to a covered person who knowingly, voluntarily, and specifically selected an out-of-network provider for health care services.
L.2018, c.32, s.11.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-12 - Listing of arbitrations on website.

26:2SS-12 Listing of arbitrations on website.
12. On or before January 31 of each calendar year, the commissioner shall consult with the Department of the Treasury, the relevant professional and occupational licensing boards within the Division of Consumer Affairs in the Department of Law and Public Safety, and the Department of Health, to obtain information to compile and make publicly available, on the department's website:
a. A list of all arbitrations filed pursuant to sections 10 and 11 of this act between January 1 and December 31 of the previous calendar year, including the percentage of all claims that were arbitrated.
(1) For each arbitration decision, the list shall include but not be limited to:
(a) an indication of whether the decision was in favor of the carrier or the out-of-network health care provider;
(b) the arbitration bids offered by each side and the award amount;
(c) the category and practice specialty of each out-of-network health care provider involved in an arbitration decision, as applicable; and
(d) a description of the service that was provided and billed for.
(2) The list of arbitration decisions shall not include any information specifically identifying the provider, carrier, or covered person involved in each arbitration decision.
b. The percentage of facilities and hospital-based professionals, by specialty, that are in-network for each carrier in this State as reported pursuant to subsection d. of section 7 of this act.
c. The number of complaints the department receives relating to out-of-network health care charges.
d. The number of and description of claims received by the State Health Benefits Program and the School Employees' Health Benefits Program for in-State emergency out-of-network health care and inadvertent out-of-network health care.
e. Annual trends on health benefits plan premium rates, total annual amount of spending on inadvertent and emergency out-of-network costs by carriers, and medical loss ratios in the State to the extent that the information is available.
f. The number of physician specialists practicing in the State in a particular specialty and whether they are in-network or out-of-network with respect to the carriers that administer the State Health Benefits Program, the School Employees' Health Benefits Program, the qualified health plans in the federally run health exchange in the State, and other health benefits plans offered in the State.
g. The results of the network audit required pursuant to section 16 of this act.
h. A summary of the information submitted to the department pursuant to subsection f. of section 6 of this act concerning the number of claims submitted by health care providers to carriers which are denied or down coded by the carrier and the reasons for the denials or down coding determinations.
i. Any other benchmarks or information obtained pursuant to this act that the commissioner deems appropriate to make publicly available to further the goals of the act.
L.2018, c.32, s.12.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-13 - Notice of protections provided.

26:2SS-13 Notice of protections provided.
13. a. A carrier shall provide a written notice, in a form and manner to be prescribed by the Commissioner of Banking and Insurance, to each covered person of the protections provided to covered persons pursuant to this act. The notice shall include information on how a consumer can contact the department or the appropriate regulatory agency to report and dispute an out-of-network charge. The notice required pursuant to this section shall be posted on the carrier's website.
b. The commissioner shall provide a notice on the department's website containing information for consumers relating to the protections provided by this act, information on how consumers can report and file complaints with the department or the appropriate regulatory agency relating to any out-of-network charges, and information and guidance for consumers regarding arbitrations filed pursuant to section 11 of this act.
L.2018, c.32, s.13.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-14 - Calculation of savings; reports.

26:2SS-14 Calculation of savings; reports.
14. a. A carrier shall calculate, as part of rate filings required to be filed under New Jersey law, the savings that result from a reduction in out-of-network claims payments pursuant to the provisions of this act. The department shall include that information in the information provided on the department's website pursuant to section 12 of this act.
b. The department shall report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), no later than 12 months after the effective date of this act and annually thereafter, on the savings to policyholders and the healthcare system that result from the provisions of this act. The report shall contain an analysis of the information compiled pursuant to section 12 of this act.
L.2018, c.32, s.14.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-15 - Violations, inducements.

26:2SS-15 Violations, inducements.
15. a. It shall be a violation of this act if an out-of-network health care provider, directly or indirectly related to a claim, knowingly waives, rebates, gives, pays, or offers to waive, rebate, give or pay all or part of the deductible, copayment, or coinsurance owed by a covered person pursuant to the terms of the covered person's health benefits plan as an inducement for the covered person to seek health care services from that provider. As the commissioner shall prescribe by regulation, a pattern of waiving, rebating, giving or paying all or part of the deductible, copayment or coinsurance by a provider shall be considered an inducement for the purposes of this subsection.
b. This section shall not apply to any waiver, rebate, gift, payment, or offer that falls within a safe harbor under federal laws related to fraud and abuse concerning patient cost-sharing, including, but not limited to, anti-kickback, self-referral, false claims, and civil monetary penalties, including any advisory opinions issued by the Centers for Medicare and Medicaid Services or the Office of Inspector General pertaining to those laws.
L.2018, c.32, s.15.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-16 - Annual audit of managed care plan.

26:2SS-16 Annual audit of managed care plan.
16. A carrier which offers a managed care plan shall provide for an annual audit of its provider network by an independent private auditing firm. The audit shall be at the expense of the carrier and the carrier shall submit the audit findings to the commissioner. The commissioner shall make the results of the audit available on the department's website. If the audit contains a determination that a carrier has failed to maintain an adequate network of providers in accordance with applicable federal or State law, in addition to any other penalties or remedies available under federal or State law, it shall be a violation of this act and the commissioner may initiate such action as the commissioner deems appropriate to ensure compliance with this act and network adequacy laws.
L.2018, c.32, s.16.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-17 - Violations; penalties.

26:2SS-17 Violations; penalties.
17. a. A person or entity that violates any provision of this act, or the rules and regulations adopted pursuant hereto, shall be liable to a penalty as provided in this subsection. The penalty shall be collected by the commissioner in the name of the State in a summary proceeding in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
(1) A health care facility or carrier that violates any provision of this act shall be liable to a penalty of not more than $1,000 for each violation. Every day upon which a violation occurs shall be considered a separate violation, but no facility or carrier shall be liable to a penalty greater than $25,000 for each occurrence.
(2) A person or entity not covered by paragraph (1) of this subsection that violates the requirements of this act shall be liable to a penalty of not more than $100 for each violation. Every day upon which a violation occurs shall be considered a separate violation, but no person or entity shall be liable to a penalty greater than $2,500 for each occurrence.
b. Upon a finding that a person or entity has failed to comply with the requirements of this act, including the payment of a penalty as determined under subsection a. of this section, the commissioner may:
(1) in the case of a carrier, initiate such action as the commissioner determines appropriate;
(2) in the case of a health care facility, refer the matter to the Commissioner of Health for such action as the Commissioner of Health determines appropriate; or
(3) in the case of a health care professional, refer the matter to the appropriate professional or occupational licensing board within the Division of Consumer Affairs in the Department of Law and Public Safety for such action as that board determines appropriate.
L.2018, c.32, s.17.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-18 - Rules, regulations.

26:2SS-18 Rules, regulations.
18. The Commissioner of Banking and Insurance, the Commissioner of Health and any relevant licensing board in the Division of Consumer Affairs in the Department of Law and Public Safety under Title 45 of the Revised Statutes may, as appropriate, adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), in order to effectuate the purposes of this act.
L.2018, c.32, s.18.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-19 - Severability.

26:2SS-19 Severability.
19. The provisions of this act shall be severable, and if any provision of this act shall be held invalid, or held invalid with respect to any particular health benefits plan or carrier, such invalidity shall not affect the other provisions hereof, or application of those provisions to other health benefits plans or carriers.
L.2018, c.32, s.19.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2SS-20 - Construction of act.

26:2SS-20 Construction of act.
20. Nothing in this act shall be construed to apply to an entity providing or administering a self-funded health benefits plan which is subject to the "Employee Retirement Income Security Act of 1974," except as provided in subsection d. of section 9 of this act for such an entity to elect to be subject to certain provisions of the act.
L.2018, c.32, s.20.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-1 - Newly diagnosed Hepatitis C cases; information, reports.

26:2T-1 Newly diagnosed Hepatitis C cases; information, reports.
1. The Commissioner of Health shall provide for the inclusion of all newly diagnosed cases of hepatitis C among those communicable diseases which are required to be reported by health care providers or other designated persons to the Department of Health pursuant to N.J.A.C.8:57-1.4 and 8:57-1.5. The commissioner shall require that such information be reported directly to the department, rather than to local health departments, as the commissioner determines necessary to assist the department to develop hepatitis C disease control measures, and shall revise these requirements as necessary to reflect technological advances which improve the ability to diagnose and treat the disease.
L.1998, c.116, s.1; amended 2001, c.357, s.6; 2012, c.17, s.305.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-2 - Written guidance for screening.

26:2T-2 Written guidance for screening.
2. The Commissioner of Health shall provide written guidance regarding screening for the hepatitis C virus to licensed physicians and public health officers which reflects current and accepted standards of medical and public health practice, consistent with the recommendations of the federal Centers for Disease Control and Prevention, and encourages appropriate screening and diagnosis of all persons at high risk for hepatitis C infection as defined by the federal centers, including, but not limited to:
(1) veterans of the United States armed forces;
(2) women who underwent a caesarian section or a premature delivery prior to 1990;
(3) persons who received blood or blood products prior to 1992;
(4) persons who received an organ or tissue transplant prior to 1990;
(5) persons who have received invasive cosmetic procedures, including body piercing and tattooing;
(6) persons who have a history of multiple sexually transmitted diseases or multiple partners;
(7) persons with a history of intravenous drug use; and
(8) such other categories of persons at high risk for hepatitis C infection as may be determined by the commissioner.
L.1998, c.116, s.2; amended 2012, c.17, s.306.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-3 - Provision of information materials to physicians, public health officers.

26:2T-3 Provision of information materials to physicians, public health officers.
3. The Commissioner of Health shall make available to licensed physicians and public health officers, in printed and electronic format, hepatitis C education and prevention information materials which reflect the recommendations of the federal Centers for Disease Control and Prevention and other relevant entities, including, but not limited to, the American Liver Foundation, for distribution to persons at high risk for hepatitis C infection as described in section 2 of this act.
L.1998, c.116, s.3; amended 2012, c.17, s.307.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-4 - Rules, regulations.

26:2T-4 Rules, regulations.
4. The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this act.
L.1998, c.116, s.4; amended 2012, c.17, s.308.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-5 - Findings, declarations relative to Hepatitis C.

26:2T-5 Findings, declarations relative to Hepatitis C.
1. The Legislature finds and declares that:
a. Hepatitis C is a silent killer, being largely asymptomatic until irreversible liver damage may have occurred;
b. Hepatitis C has been characterized by the World Health Organization as a disease of primary concern to humanity;
c. Hepatitis C currently infects approximately 4.5 million persons in the United States; and each year, there are some 30,000 new infections nationwide;
d. The federal Centers for Disease Control and Prevention estimate that approximately 12,000 persons die annually from the consequences of hepatitis C, and this number continues to grow each year;
e. It is estimated that approximately 200,000 New Jersey citizens are infected with hepatitis C;
f. The disease is considered to be such a public health threat that the United States Department of Health and Human Services has initiated a comprehensive plan to address this significant health problem, beginning with the identification of, and notification to, hundreds of thousands of persons who were inadvertently exposed to hepatitis C through blood transfusions;
g. In the absence of a vaccine for hepatitis C, emphasis must be placed on other means of awareness and prevention of this disease, including, but not limited to, education of persons at high risk for hepatitis C as defined by the federal Centers for Disease Control and Prevention, and the Occupational Safety and Health Administration in the U.S. Department of Labor, including but not limited to, police officers, correctional officers, firefighters, including volunteers, health care workers, emergency services personnel, employees of the State's developmental centers and the general public; and
h. New Jersey has established itself at the forefront of the fight against hepatitis C by becoming the first State in the nation to establish a comprehensive awareness program pursuant to P.L.1998, c.116 (C.26:2T-1 et seq.), and through the enactment of this act will ensure an optimal approach to controlling this lethal disease.
L.2001,c.357,s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-6 - Definitions relative to hepatitis C.

26:2T-6 Definitions relative to hepatitis C.
2. As used in this act:
"Commissioner" means the Commissioner of Health.
"HCV" means the hepatitis C virus.
"Program" means the hepatitis C education, prevention, and screening program established pursuant to this act.
L.2001, c.357, s.2; amended 2012, c.17, s.309.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-8 - Hepatitis C advisory board.

26:2T-8 Hepatitis C advisory board.
4. a. The commissioner shall establish a hepatitis C advisory board to provide advice and recommendations to the commissioner on, and to monitor, the implementation and operation of the program, and to evaluate the effectiveness of the program in meeting its objectives. The advisory board may also provide advice and recommendations to the commissioner on such other matters relating to hepatitis C as a majority of its members deem appropriate.
b. The commissioner shall appoint as members of the advisory board persons with a demonstrated expertise and interest in hepatitis C, including, but not limited to, health care professionals and persons with hepatitis C, and including representation among the various geographic regions and ethnic groups within the State. The advisory board shall include four physicians who include one internist, one hematologist and two hepatologists; one clinical researcher specializing in diseases of the liver; and two members who are not physicians or clinical researchers, at least one of whom is a veteran of the United States armed forces who has hepatitis C.
c. The members of the advisory board shall serve without compensation, but shall be entitled to reimbursement for necessary expenses incurred in the performance of their duties.
d. The advisory board shall organize as soon as may be practicable after the appointment of its members and shall select a chairman from among its members and a secretary who need not be a member of the board.
L.2001,c.357,s.4.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2T-9 - Annual report to Governor, Legislature.

26:2T-9 Annual report to Governor, Legislature.
5. The commissioner, in consultation with the hepatitis C advisory board, shall report to the Governor and the Legislature, no later than 12 months after the effective date of this act and annually thereafter, on the activities of the program and the effectiveness of the program in meeting its objectives. The report shall clearly describe the guidelines, assessments and strategies employed by the commissioner in developing, implementing and evaluating the program. In addition, the commissioner shall seek to include in the report information on the proportion of acute versus chronic HCV infection among persons with HCV in the State and information about HCV infection that is specific to various populations within the State. The commissioner shall accompany the report with any recommendations that the commissioner desires to make for administrative or legislative action relating to hepatitis C education, prevention, screening or treatment.
L.2001,c.357,s.5.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2U-1 - Chronic Fatigue Syndrome resources network established.

26:2U-1 Chronic Fatigue Syndrome resources network established.
1. The Commissioner of Health shall establish a Statewide network of resources to provide the following services to persons with chronic fatigue syndrome, also known as chronic fatigue immune dysfunction syndrome: physician training and patient education programs, and a public awareness campaign.
L.1999, c.366, s.1; amended 2012, c.17, s.311.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2U-2 - Informational manual; preparation, availability.

26:2U-2 Informational manual; preparation, availability.
2. The Department of Health, in consultation with the New Jersey Chronic Fatigue Syndrome Association, Inc., and the Academy of Medicine of New Jersey, shall prepare and make available to all health care providers in the State, upon request, a manual which provides information about the clinical significance, diagnosis and treatment of chronic fatigue syndrome. The manual may contain any other information which the Commissioner of Health deems necessary and may be revised by the department whenever new information about chronic fatigue syndrome becomes available. The department shall publicize and make available the manual to the maximum extent possible.
L.1999, c.66, s.2; amended 2012, c.17, s.312; 2012, c.45, s.115.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2U-3 - Rules, regulations.

26:2U-3 Rules, regulations.
3. The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this act.
L.1999, c.66, s.3; amended 2012, c.17, s.313.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2W-1 - Cancer Awareness Education and Research Program.

26:2W-1 Cancer Awareness Education and Research Program.
1. The Commissioner of Health shall establish a Cancer Awareness, Education and Research Program to provide the following: support for cancer medical research; physician education and awareness; and patient education and screening services, particularly for members of minority groups.
L.1999, c.361, s.1; amended 2012, c.17, s.316.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2W-2 - Rules, regulations.

26:2W-2 Rules, regulations.
2. The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this act.
L.1999, c.361, s.2; amended 2012, c.17, s.317.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2W-3 - Breast cancer public awareness campaign.

26:2W-3 Breast cancer public awareness campaign.
1. a. The Commissioner of Health shall establish a breast cancer public awareness campaign, as a component of the Cancer Awareness, Education and Research Program established pursuant to P.L.1999, c.361 (C.26:2W-1 et seq.), to promote awareness and outreach throughout the State in regard to breast cancer screening services. The public awareness campaign shall be established in accordance with accepted public health practice and recommendations of the federal Centers for Disease Control and Prevention, and within the limits of funds appropriated pursuant to this act and any other resources available for the purposes thereof.
b. For the purposes of this act, the commissioner shall, at a minimum:
(1) develop and implement a Statewide plan to promote public awareness among members of the public, community-based organizations, and health care providers, and encourage more referrals to breast cancer screening services;
(2) distribute promotional incentives for free or discounted items to be provided to women by local retail businesses that will encourage them to undergo mammography and become educated about breast cancer;
(3) provide for the use of public service announcements and printed materials in both English and Spanish;
(4) seek to disseminate information through a variety of entities, including, but not limited to, primary care sites, health care facilities, local health departments and clinics, county offices on the aging, pharmacies, libraries, YWCAs and YMCAs, senior centers, houses of worship, programs that serve victims of domestic violence, other community-based outreach programs and organizations, and the Internet;
(5) consult and seek to collaborate with at least the following entities to effectuate the public awareness campaign: the New Jersey Primary Care Association, the American Cancer Society, the Medical Society of New Jersey, the New Jersey Hospital Association, Planned Parenthood, AARP, the New Jersey Advisory Commission on the Status of Women, the New Jersey State Commission on Cancer Research, The Cancer Institute of New Jersey, the New Jersey Pharmacists Association, the Health Research and Educational Trust of New Jersey, and The Peer Review Organization of New Jersey, Inc.;
(6) establish and publicize the availability of a toll-free telephone number operated by the Department of Health to provide information and referral to members of the general public about breast screening services, with particular emphasis on facilitating free and reduced charge screening for low-income and uninsured women; and
(7) seek to secure the use of such funds or other resources from private nonprofit or for-profit sources or the federal government to effectuate the purposes of this act as may be available therefor, which shall be used to supplement and shall not supplant State funds used to carry out the purposes of this act.
L.2001, c.196, s.1; amended 2012, c.17, s.318.