Read the full stored bill text
A4335
ASSEMBLY, No. 4335
STATE OF NEW JERSEY
222nd LEGISLATURE
�
INTRODUCED FEBRUARY 19, 2026
Sponsored by:
Assemblywoman� SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Co-Sponsored by:
Assemblywoman Haider
SYNOPSIS
���� Requires health insurance carriers and Medicaid to
provide coverage for planned home childbirth.
CURRENT VERSION OF TEXT
���� As introduced.
��
An Act
concerning health insurance coverage of planned
home childbirth 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
this act, shall provide coverage for costs associated with planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the hospital
service corporation 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.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 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 this
act, shall provide coverage for costs associated with planned home childbirth,
including, but not limited to, services provided by a health care provider,
services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the medical
service corporation 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.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 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
this act, shall provide coverage for costs associated with planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the health
service corporation 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.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 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 costs associated with planned home childbirth, including,
but not limited to, services provided by a health care provider, services
provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services 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.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 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
this act, shall provide coverage for costs associated with planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services 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.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 6.��� 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 this act, shall
provide coverage for costs associated with planned home childbirth, including,
but not limited to, services provided by a health care provider, services
provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the contract.
���� c.���� This section shall
apply to those policies in which the health maintenance organization has
reserved the right to change the schedule of charges for enrollee coverage.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 7.��� 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 costs associated with planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the health
benefits plan.
���� c.���� This section shall
apply to those health benefits plans in which the carrier has reserved the
right to change the premium.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 8.��� 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 costs associated with planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the health
benefits plan.
���� c.���� This section shall
apply to those policies in which the carrier has reserved the right to change
the premium.
���� d.��� As used in this section,
�health care provider� means an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� �Health
care provider� includes a family practice physician, obstetrician, advanced
practice nurse, registered professional nurse, licensed practical nurse,
certified professional midwife, certified nurse midwife, or certified midwife.
���� 9.��� a.� The State Health
Benefits Commission, on or after the effective date of this act, shall provide
coverage for costs associated with planned home childbirth, including, but not
limited to, services provided by a health care provider, services provided by a
doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the contract.
���� c.���� As used in this
section, �health care provider� means an individual or entity which, acting
within the scope of its licensure or certification, provides health care
services.� �Health care provider� includes a family practice physician, obstetrician,
advanced practice nurse, registered professional nurse, licensed practical
nurse, certified professional midwife, certified nurse midwife, or certified
midwife.
���� 10.� a.� The School Employees�
Health Benefits Commission on or after the effective date of this act, shall
provide coverage for costs associated with planned home childbirth, including,
but not limited to, services provided by a health care provider, services
provided by a doula, and equipment and medical supplies.
���� b.��� The coverage shall be
provided to the same extent as for any other health care services under the contract.
���� c.���� As used in this
section, �health care provider� means an individual or entity which, acting
within the scope of its licensure or certification, provides health care
services.� �Health care provider� includes a family practice physician, obstetrician,
advanced practice nurse, registered professional nurse, licensed practical
nurse, certified professional midwife, certified nurse midwife, or certified
midwife.
���� 11.� a.� Notwithstanding the
provisions of any State law or regulation to the contrary, the Division of
Medical Assistance and Health Services in the Department of Human Services, or
a managed care organization contracted with the division to provide benefits
under NJ FamilyCare, shall cover the costs incurred for a planned home
childbirth, including, but not limited to, services provided by a health care
provider, services provided by a doula, and equipment and medical supplies,
when the services are provided to a beneficiary of NJ FamilyCare by an
in-network health care provider.
���� b.��� The Commissioner of
Human Services shall apply for such State plan amendments or waivers as may be
necessary to implement the provisions of this section and to secure federal
financial participation for NJ FamilyCare expenditures under the Medicaid program
and Children�s Health Insurance Program.
���� c.���� The department may take
any administrative action necessary to effectuate the provisions of this
section, including modifying or amending any applicable contract or
promulgating, amending, or repealing any guidance, guidelines, or rules, which
rules or amendments thereto shall be effective immediately upon filing with the
Office of Administrative Law for a period not to exceed 12 months, and may,
thereafter, be amended, adopted or readopted in accordance with the provisions
of the �Administrative Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.).
���� d.��� As used in this section:
���� �Health care provider� means
an individual or entity which, acting within the scope of its licensure or
certification, provides health care services.� �Health care provider� includes a
family practice physician, obstetrician, advanced practice nurse, registered
professional nurse, licensed practical nurse, certified professional midwife,
certified nurse midwife, or certified midwife.
���� �NJ FamilyCare� means the
program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which
includes the Medicaid program and the Children�s Health Insurance Program.
���� 12.� Sections 1 through 10 of
this act shall take effect on the 120th day following enactment, and shall
apply to all contracts 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.� Section 11 of this
act shall take effect two years following enactment.
STATEMENT
���� This bill requires health
insurance carriers (health, hospital and medical service corporations, health
maintenance organizations, and insurance companies), the State Health Benefits
Program, the School Employees� Health Benefits Program, and the State Medicaid
and NJ FamilyCare programs to provide coverage for expenses incurred in planned
home childbirth.� The required coverage is to include, but not be limited to,
costs associated with services provided by a health care provider, services
provided by a doula, and equipment and medical supplies.
���� Under the bill, a �health care
provider� is defined to mean an individual or entity which, acting within the
scope of its licensure or certification, provides health care services.� The
term includes a family practice physician, obstetrician, advanced practice
nurse, registered professional nurse, licensed practical nurse, certified
professional midwife, certified nurse midwife, or certified midwife.