Senate Commerce Committee Statement to Senate, No. 3558 — State of New Jersey (February 10, 2025)

Summary

The Senate Commerce Committee of the State of New Jersey, in a statement dated February 10, 2025, reports favorably Senate Bill No. 3558. The bill requires health insurers and the State Medicaid program to provide coverage for medical expenses incurred in the treatment of stuttering, including habilitative speech therapy and rehabilitative speech therapy. Whether treatment is a medical necessity is to be determined by the covered person's medical doctor. Coverage must be provided whether services are delivered in-person or through telemedicine or telehealth, without prior authorization or other utilization management requirements, and without cost-sharing. The bill defines both kinds of speech therapy.

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SENATE COMMERCE COMMITTEE

STATEMENT TO

SENATE, No.
3558

STATE
OF NEW JERSEY

DATED: FEBRUARY
10, 2025

The Senate Commerce Committee reports favorably Senate
Bill No. 3558.

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) and the State Medicaid program to provide coverage for medical
expenses incurred in the treatment of stuttering, including habilitative speech
therapy and rehabilitative speech therapy. Whether treatment is a medical
necessity is to be determined by the covered person’s medical doctor.

The
bill requires coverage to be provided whether the services are delivered
in-person or through telemedicine or telehealth, without the imposition of any
prior authorization or other utilization management requirements, and without
cost-sharing.

Pursuant
to the bill, “habilitative speech therapy" means speech therapy that helps
a person keep, learn, or improve skills and functioning for daily living; and
“rehabilitative speech therapy" means speech therapy that helps a person
restore or improve skills and functioning for daily living that have been lost
or impaired.

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