Title 26, Title 26: HEALTH AND VITAL STATISTICS

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 …

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, copay…

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 f…

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…

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, adop…

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 appl…

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 billin…

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 …

26:2SS-3 Definitions relative to out-of-network health care charges. 3. As used in this act: "Carrier" means an entity that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits pla…

26:2SS-4 Disclosures by health care facility. 4. a. Prior to scheduling an appointment with a covered person for a non-emergency or elective procedure and in terms the covered person typically understands, a health care facility shall: (1) disclose to the covered person whether t…

26:2SS-5 Disclosures by health care professional relative to participation in health benefits plans. 5. a. Except as provided in subsection f. of this section, a health care professional shall disclose to a covered person in writing or through an internet website the health benef…

26:2SS-6 Website updates of addition, deletion of provider from carrier's network. 6. a. A carrier shall update the carrier's website within 20 days of the addition or termination of a provider from the carrier's network or a change in a physician's affiliation with a facility, p…

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 o…

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 Em…

26:2SS-9 Responsibilities of carrier relative to inadvertent out-of-network services. 9. Notwithstanding any law, rule, or regulation to the contrary: a. With respect to a carrier, if a covered person receives inadvertent out-of-network services, or services at an in-network or o…

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 designa…

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…

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 whi…

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.

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 Organizat…

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…

26:2T-7 Hepatitis C education, prevention and screening program. 3. In consultation with the hepatitis C advisory board established pursuant to section 4 of P.L.2001, c.357 (C.26:2T-8), the Commissioner of Health shall establish a hepatitis C education, prevention, and screening …

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 …

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 t…

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: ph…

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 St…

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.

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 sc…

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.

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 prom…

26:2W-4 Short title. 1. This act shall be known and may be cited as the "Firefighter Cancer Registry Act of 2019." L.2019, c.113, s.1.

26:2W-5 Firefighter cancer registry. 2. a. The Commissioner of Health shall develop and maintain a firefighter cancer registry, which shall be a voluntary registry of firefighters to collect relevant history and occupational information from firefighters that can be linked to ava…

26:2W-6 DOH to review data, provide availability to public. 3. a. The Department of Health shall review data reported to the registry to identify trends in cancer incidence among firefighters throughout the State, including identifying any regional disparities in cancer incidence…

26:2W-7 Report to Governor, Legislature. 4. Commencing one year after the effective date of this act, and annually thereafter, the department shall submit a report to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, concerning its fin…

26:2W-8 Confidentiality of information. 5. Names and individual identification data collected pursuant to the provisions of this act shall not be disclosed unless required by law, and nothing in this act shall be construed to require disclosure of any private or confidential heal…

26:2X-1 Public awareness campaign relative to meningitis. 1. The Commissioner of Health shall establish a public awareness campaign to inform the general public about the clinical significance of meningitis and its public health implications, including its causes and the most eff…

26:2X-2 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.2000, c.25, s.3; amended 2012, c.17, s.320.

26:2X-3 Development of educational fact sheet concerning meningococcal meningitis. 1. The Commissioner of Health, in consultation with the Commissioner of Education, shall develop an educational fact sheet concerning meningococcal meningitis for distribution to parents or guardia…

26:2Y-1 Short title. 1. This act shall be known and may be cited as the "New Jersey Adult Family Care Act." L.2001,c.304,s.1.

26:2Y-10 Rights of client of adult family care home. 10. a. A client of an adult family care home may not be deprived of any civil or legal rights, benefits or privileges guaranteed by law, the New Jersey Constitution, or the Constitution of the United States solely by reason of …

26:2Y-11 Rules, regulations. 13. 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.2001, c.304, s.13; amended 2012, c.17, s.324.

26:2Y-2 Findings, declarations relative to adult family care. 2. The Legislature finds and declares that: a. In the absence of appropriate housing with supportive services, many elders or people with physical disabilities are often subject to inappropriate, premature, or overexte…

26:2Y-3 Definitions relative to adult family care. 3. As used in this act: "Activities of daily living" or "ADL" means functions and tasks for self-care which are performed either independently or with supervision or assistance, which include, but are not limited to, mobility, tr…

26:2Y-4 Licensing required for operation of adult family care home. 4. a. No person may operate an adult family care home unless the person is licensed as an adult family care caregiver in accordance with this act. A person may not be licensed as an adult family care caregiver un…

26:2Y-5 Criminal history record background check for applicants for licensure as adult family caregiver. 5. a. The department shall establish a program to check the criminal history record background of any applicant for licensure as an adult family care caregiver as well as any …

26:2Y-6 Licensure required for adult family care sponsor agency. 6. a. No person, firm, partnership, corporation, limited liability company or association may operate, conduct or hold itself out to the public as an adult family care sponsor agency unless it is duly licensed as an…