52:14-17.29e Biologically-based mental illness terms, conditions, in health benefits contracts.
2.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 or medical expense benefits shall provide coverage for biologically-based mental illness under the same terms and conditions as provided for any other sickness under the contract.
b.Nothing in this section shall be construed to change the manner in which a carrier determines:
(1)whether a mental health care service meets the medical necessity standard as established by the carrier; or
(2)which providers shall be entitled to reimbursement for providing services for mental illness under the contract.
c.The commission shall provide notice to employees regarding the coverage required by this section in accordance with this subsection and regulations promulgated by the Commissioner of Health and Senior Services pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). The notice shall be in writing and prominently positioned in any literature or correspondence and shall be transmitted at the earliest of: (1) the next mailing to the employee; (2) the yearly informational packet sent to the employee; or (3) July 1, 2000. The commission shall also ensure that the carrier under contract with the commission, upon receipt of information that a covered person is receiving treatment for a biologically-based mental illness, shall promptly notify that person of the coverage required by this section.
L.1999,c.441,s.2.
Section: Previous 52-14-17.28d 52-14-17.28e 52-14-17.29 52-14-17.29a 52-14-17.29b 52-14-17.29c 52-14-17.29d 52-14-17.29e 52-14-17.29f 52-14-17.29g 52-14-17.29h 52-14-17.29i 52-14-17.29j 52-14-17.29k 52-14-17.29l Next
Last modified: October 11, 2016