Joe Simonetta
Public Strategies Impact

Tracie DeSarno
Public Strategies Impact

As we write this article, the Legislature is about to introduce a budget bill for FiscalYear 2022 which must be signed by Governor Murphy by July 1, 2021.We are hopeful that NJAAP’s top state budget priority, funding for the Pediatric Psychiatry Collaborative, will be funded at the current funding level of $5 million.

A3548, legislation that requires insurance coverage for expenses incurred in screening adolescents between the ages of 12 and 18 for major depressive disorder, so long as screening for major depressive disorder in adolescents continues to receive a rating of “A” or “B” from the United States Preventative Services Task Force was signed by Governor Murphy. Through the first six months of 2021 we have worked on several pieces of legislation that continue to work through the legislative process including:

A970/S2599, legislation that establishes in the Department of Education, the Mental Health Screening in Schools Grant Program in which school districts may apply for funding to make an annual health screening for depression available to each student in the grades seven through 12.The legislation lays out various conditions school districts are required to meet in implementing depression screening programs under the grant program and the information to be included in the applications for grant funding.The legislation requires the Commissioner of Education to develop a report, or contract with a research institution or organization to develop a report, evaluating depression screening programs in school districts participating in the Mental Health Screening in Schools Grant Program as well as other school districts that have developed depression screening programs. This legislation was significantly amended. As it was originally introduced it generally required boards of education to ensure that each student in the grades seven through 12 annually receives a health screening for depression without providing any adequate follow up for students identified as having screened positively for depression.This bill is presently on the Governor’s desk.

S2559/A4179, legislation that revises the telemedicine and telehealth law to require health benefits plans, Medicaid and NJ FamilyCare, and the State Health Benefits Program and School Employees’ Health Benefits Program, to provide expanded coverage for services provided using telemedicine and telehealth. Specifically, the legislation requires that reimbursement for telemedicine and telehealth services for physical and behavioral health care be equal to the reimbursement rate for the same services when they are provided in person, provided the services are otherwise covered when provided in person in New Jersey. Current law provides telemedicine and telehealth services may be reimbursed up to the amount at which the service would be reimbursed if provided in person.The legislation provides that if a telemedicine or telehealth organization does not provide a given service on an in-person basis in New Jersey, the coverage parity requirements of the bill will not apply. And the legislation prohibits health benefits plans, Medicaid and NJ FamilyCare, and the SHBP and SEHBP from imposing “place of service” requirements on providers or on patients in connection with telemedicine and telehealth services.

S225/A679, legislation that provides that a student- athlete or cheerleader who sustains a concussion or other head injury is ineligible to return to competition or practice until he/she returns to regular school activities and is no longer experiencing symptoms of the injury when conducting those activities. Under the bill, the return of the student-athlete or cheerleader must be in accordance with the CDCs’ graduated, six-step “Return to Play Progression” recommendations.The bill also requires the Department of Education to revise its athletic head injury safety training program to include information on the CDCs’ graduated, six-step “Return to Play Progression” recommendations. The bill also requires a school district to revise its written policy concerning the prevention and treatment of sports-related concussions and other head injuries to include the CDCs’ graduated, six-step “Return to Play Progression” recommendations.

S3000, legislation that codifies and establishes certain network adequacy standards for pediatric primary and specialty care in the Medicaid program. The bill defines network adequacy to mean the adequacy of the provider network with respect to the scope and type of health care benefits provided by the managed care plan, the geographic service area covered by the provider network, and access to medical specialists pursuant to the standards in the regulations promulgated pursuant to section 19 of P.L.1997, c.192 (C.26:2S-18) and in the existing contract between a managed care organization and the Division of Medical Assistance and Health Services (DMAHS) in the Department of Human Services.

S3506, legislation that prohibits a health care professional in a licensed health care facility from performing certain prohibited surgical procedures on a person born with variations in their sex characteristics, who is 12 years of age or under, unless the surgery is required to address an immediate risk of physical harm.The surgical procedures prohibited under the bill include: clitoroplasty; clitoral reduction; clitoral recession, including corporal-sparing procedures; gonadectomy; any procedure that lengthens or reroutes the urethra from its native orifice; vaginoplasty; urogenital sinus mobilization; and vaginal exteriorization.

S3558, legislation that requires physicians, physician assistants, advanced practice nurses, and other authorized prescribers to obtain informed electronic or written consent prior to prescribing psychotropic medications that are accompanied by a “black box warning,” which consent is to include an electronic or a written acknowledgement that the patient or the patient’s guardian received notification about the black box warning. The bill specifies that in cases where electronic or written consent cannot be obtained but oral consent is provided, the prescriber must make a notation in the patient’s file indicating the date and circumstances of the informed consent.