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A4255
ASSEMBLY, No. 4255
STATE OF NEW JERSEY
222nd LEGISLATURE
�
INTRODUCED FEBRUARY 19, 2026
Sponsored by:
Assemblywoman� SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Assemblywoman� SHAMA A. HAIDER
District 37 (Bergen)
SYNOPSIS
���� Requires health insurance coverage of postpartum
pelvic floor physical therapy.
CURRENT VERSION OF TEXT
���� As introduced.
��
An Act
concerning health insurance coverage and pelvic floor
physical therapy 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 pursuant to P.L.1938,
c.366 (C.17:48-1 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
P.L.��� , c.��� (C.������� ) (pending before the Legislature as this bill),
shall include benefits for pelvic floor physical therapy during the postpartum
period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� 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 pursuant to P.L.1940, c.74
(C.17:48A-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
P.L.��� , c.��� (C.������� ) (pending before the Legislature as this bill),
shall include benefits for pelvic floor physical therapy during the postpartum
period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� 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 pursuant to P.L.1985,
c.236 (C.17:48E-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
P.L.��� , c.��� (C.������� ) (pending before the Legislature as this bill),
shall include benefits for pelvic floor physical therapy during the postpartum
period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� 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 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 P.L.��� , c.���
(C.������� ) (pending before the Legislature as this bill), shall include
benefits for pelvic floor physical therapy during the postpartum period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� This section shall
apply to those individual health insurance 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 pursuant to
N.J.S.17B:27-26 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
P.L.��� ,
c.��� (C.������� ) (pending before the Legislature as this bill), shall include
benefits for pelvic floor physical therapy during the postpartum period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� This section shall
apply to those group health insurance 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
P.L.��� , c.��� (C.������� ) (pending before the Legislature as this bill),
shall include benefits for pelvic floor physical therapy during the postpartum
period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the plan.
���� c.���� This section shall
apply to those health benefits 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
P.L.��� , c.��� (C.������� ) (pending before the Legislature as this bill),
shall include benefits for pelvic floor physical therapy during the postpartum
period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the plan.
���� c.���� This section shall
apply to those health benefits plans in which the carrier has reserved the
right to change the premium.
���� 8.��� a.� A health maintenance
organization contract for health care services that is delivered, issued,
executed, or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-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 P.L.��� ,
c.��� (C.������� ) (pending before the Legislature as this bill), shall include
benefits for pelvic floor physical therapy during the postpartum period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� This section shall
apply to those contracts for health care services under 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 by the
commission on or after the effective date of P.L.��� , c.��� (C.������� )
(pending before the Legislature as this bill) that provides hospital and
medical expense benefits shall include benefits for pelvic floor physical
therapy during the postpartum period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� 10.� a.� The School Employees�
Health Benefits Commission shall ensure that every contract purchased by the
commission on or after the effective date of P.L.��� , c.��� (C.������� )
(pending before the Legislature as this bill) that provides hospital and medical
expense benefits shall include benefits for pelvic floor physical therapy
during the postpartum period.
���� For the purposes of this
section, �postpartum period� means one year after childbirth.
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� 11.� This act shall take
effect on the first day of the seventh month next following enactment and shall
apply to all health benefits plans that are 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.
STATEMENT
���� This bill requires health
insurers (health, hospital, and medical service corporations, commercial
individual and group health insurers, health maintenance organizations, health
benefits plans issued pursuant to the New Jersey Individual Health Coverage and
Small Employer Health Benefits Programs, the State Health Benefits Program, and
the School Employees� Health Benefits Program) to provide coverage for pelvic
floor physical therapy during the postpartum period.� Under the bill, the
�postpartum period� is defined to mean one year after childbirth.