ASSEMBLY FINANCIAL INSTITUTIONS AND INSURANCE COMMITTEE

STATEMENT TO

[First Reprint]

SENATE, No. 1439

STATE OF NEW JERSEY

DATED:  DECEMBER 9, 2024

      The Assembly Financial Institutions and Insurance Committee reports favorably Senate Bill No. 1439 (1R).

      The bill requires health benefits coverage for an additional orthotic or prosthetic appliance from any licensed orthotist or prosthetist, any certified pedorthist, or licensed podiatrist, if the covered person’s physician determines that the additional appliance is necessary to enable the covered person to engage in physical and recreational activities, including running, bicycling, swimming, climbing, skiing, snowboarding, and team and individual sports.  The reimbursement for the additional orthotic or prosthetic appliance is at the same rate as reimbursement for the appliances under the federal Medicare reimbursement schedule.

      The bill also requires health benefits coverage for orthotic or prosthetic appliances, as well as additional orthotics or prosthetic appliances for engaging in physical and recreational activities, obtained from a licensed podiatrist.

      Current law requires health benefits coverage for expenses incurred in obtaining an orthotic or prosthetic appliance from any licensed orthotist or prosthetist, or any certified pedorthist, as determined medically necessary by the covered person's physician, but does not require coverage of an additional appliance for physical or recreational activities.

      The bill would apply to hospital, medical, and health service corporations; commercial individual, small employer, and larger group insurers; health maintenance organizations; and the State Health Benefits Program and the School Employees’ Health Benefits Program.

      As reported by the committee, Senate Bill No. 1439 (1R) is identical to Assembly Bill No. 3856 (1R), which was also amended and reported by the committee on this date.