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A2176
ASSEMBLY, No. 2176
STATE OF NEW JERSEY
222nd LEGISLATURE
�
PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION
Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Assemblywoman ELLEN J. PARK
District 37 (Bergen)
SYNOPSIS
���� Requires health insurance coverage of at-home
rehabilitation services.
CURRENT VERSION OF TEXT
���� Introduced Pending Technical Review by Legislative
Counsel.
��
An Act
concerning at-home rehabilitation 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.�� No group or
individual hospital service corporation contract 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
contract provides benefits to any subscriber or other person covered thereunder
for expenses incurred in conducting
at-home
rehabilitation services.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all contracts in which the hospital service corporation
has reserved the right to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 2.��� a.�� No group or
individual medical service corporation contract 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
contract provides benefits to any subscriber or other person covered thereunder
for expenses incurred in conducting at-home rehabilitation services.
���� b.��� These benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all contracts in which the medical services corporation
has reserved the right to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 3.��� a.�� No group or
individual health service corporation contract 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
contract provides benefits to any subscriber or other person covered thereunder
for expenses incurred in conducting at-home rehabilitation services.
���� b.��� These benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all contracts in which the health services corporation
has reserved the right to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 4.��� a.� 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
any named insured or other person covered thereunder for expenses incurred in
conducting at-home rehabilitation services.
���� b.��� These benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� The provision of this
section shall apply to all policies in which the insurer has reserved the right
to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 5.��� a.� No group 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
any named insured or other person covered thereunder for expenses incurred in
conducting at-home rehabilitation services.
���� b.��� These benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� The provisions of this
section shall apply to all policies in which the insurer has reserved the right
to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 6.��� a.� Notwithstanding any
provision of law to the contrary, a certificate of authority to establish and
operate a health maintenance organization in this State shall not be issued or
continued by the Commissioner of Banking and Insurance on or after the effective
date of this act unless the health maintenance organization provides health
care services to any enrollee for the use of at-home rehabilitation services.
���� b.��� These health care
services shall be provided to the same extent as for any other medical
condition under the enrollee agreement.
���� c.���� The provisions of this
section shall apply to all enrollee agreements in which the health maintenance
organization has reserved the right to change the schedule of charges.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 7.��� a.� Every individual
health benefits plan that 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, on or after the effective date of this act,
shall provide benefits to any person covered thereunder for expenses incurred
in conducting at-home rehabilitation services.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the health
benefits plan.
���� c.���� The provisions of this
section shall apply to all health benefit plans in which the carrier has
reserved the right to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 8.��� a. Every small employer
health benefits plan that 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, on or after the effective date of this act,
shall provide benefits to any person covered thereunder for expenses incurred
in conducting at-home rehabilitation services.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the health
benefits plan.
���� c.���� The provisions of this
section shall apply to all health benefit plans in which the carrier has
reserved the right to change the premium.
���� d.��� As used in this section,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.
���� 9.��� a.
The State Health Benefits Commission shall ensure
that every contract purchased by the commission on or after the effective date
of this act that provides hospital and medical expense benefits shall provide
coverage for expenses incurred in
conducting at-home rehabilitation
services.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� As used in this
section, �at-home rehabilitation� means the treatment of an individual suffering
from a functional physical or mental impairment due to injury or disease through
use of medical equipment or other means and within the individual�s home.
���� 10.� This act shall take
effect immediately.
STATEMENT
���� This bill requires health
insurance carriers, including insurance companies, health service corporations,
hospital service corporations, medical service corporations, health maintenance
organizations authorized to issue health benefits plans in New Jersey, and any
entity contracted to administer health benefits in connection with the State
Health Benefits Program or School Employees� Health Benefits Program, to cover
at-home rehabilitation services.�
���� For an individual recovering
from surgery or suffering from a debilitating disease or disability, the burden
of traveling to and from a rehabilitation facility may be too large to
overcome.� With the rise of the coronavirus 2019 pandemic, many individuals
have also been unable to visit a rehabilitation facility for treatment or have
delayed treatment for fear of contracting the virus.� Thus, requiring carriers
to cover at-home rehabilitation services would alleviate these issues by
providing access to treatment from within the patient�s home, without fear of
aggravating a disability or contracting a deadly virus. As defined in the bill,
�at-home rehabilitation� means the treatment of an individual suffering from a
functional physical or mental impairment due to injury or disease through use
of medical equipment or other means and within the individual�s home.