Sponsored by:
Senator JOHN J. BURZICHELLI
District 3 (Cumberland, Gloucester and Salem)
SYNOPSIS
Establishes and requires coverage for routine opt-out HIV testing during provision of medical care in certain settings.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning HIV testing and supplementing and amending various parts of statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Legislature finds and declares:
(1) HIV (human immunodeficiency virus) is a virus that attacks the body's immune system that without treatment can lead to acquired immunodeficiency syndrome (AIDS).
(2) There is currently no effective cure and once people get HIV, they have it for life, but proper medical care can control the virus.
(3) Testing for HIV is the only way to determine if a person is living with the virus.
(4) If individuals do not know their HIV status, HIV transmission cannot be eliminated.
(5) The Centers for Disease Control and Prevention (CDC) recommend that every person between the ages of 13 and 64 years old receive an HIV test at least once, regardless of risk.
(6) The Legislature therefore determines that is in the public interest to establish routine HIV testing in the State in order to promote early detection and treatment of HIV, reduce transmission of HIV by increasing individual awareness of HIV status, and align with CDC recommendations for HIV screening.
b. As a part of routine medical care involving the collection of specimen from a patient for laboratory examination:
(1) the testing of HIV shall be included for patients receiving care in the following settings:
(a) primary care settings;
(b) emergency departments of licensed general hospitals in this State; and
(c) any other appropriate health care setting as determined by the Commissioner of Health;
(2) separate written consent for HIV testing shall not be required when a patient, or the patient’s parent or legal guardian as applicable, has already provided general consent for medical care in settings listed pursuant to paragraph (1) of this subsection;
(3) each patient listed under paragraph (1) of this subsection shall be tested for HIV, unless:
(a) the patient, or the patient’s parent or legal guardian as applicable, opts out of the testing;
(b) if the patient is an adult, the patient lacks decision-making capacity;
(c) the patient requires emergency care that prevents the testing from occurring;
(d) the patient is receiving hospice care through a licensed hospice; or
(e) the patient already has a confirmed diagnosis of HIV;
(4) testing of a patient for HIV conducted pursuant to this section shall be voluntary and free of coercion;
(5) the provision of pre-test counseling shall not be required prior to HIV testing conducted pursuant to this section; and
(6) a patient shall be notified that testing shall be performed unless the patient, or the patient’s parent or legal guardian as applicable, declines the testing. The health care provider performing the test shall maintain documentation consistent with any applicable federal and State HIV clinical practice guidelines concerning medical record documentation. If a patient declines to be tested for HIV, the declination shall be documented in the patient’s medical record.
b. The Commissioner of Health shall establish guidelines regarding:
(1) health care providers providing timely notification to a patient, or the patient’s parent or legal guardian as applicable, whose test result is positive, counseling about the significance of the test result, providing referrals to appropriate follow-up care, and coordinating with the Department of Health as necessary; and
(2) a model notice for providers to use when informing patients of the HIV test.
3. a. No group or individual hospital service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the hospital service corporation has reserved the right to change the premium.
4. a. No group or individual medical service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the group or individual medical service corporation has reserved the right to change the premium.
5. a. No group or individual health service corporation contract providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the contract provides benefits to any subscriber or other person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all contracts in which the health service corporation has reserved the right to change the premium.
6. a. Except as provided in paragraph (2) of this subsection, no individual health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the policy provides benefits to any named insured or other person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium.
7. a. No group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, unless the policy provides benefits to any named insured or other person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium.
8. a. Every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium.
9. a. Every small employer health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.) or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide benefits to any person covered thereunder for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium.
10. a. Notwithstanding any provision of law to the contrary, a certificate of authority to establish and operate a health maintenance organization in this State shall not be issued or continued by the Commissioner of Banking and Insurance on or after the effective date of this act unless the health maintenance organization provides health care services to any enrollee for expenses incurred for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The provisions of this
section shall apply to those contracts for health care services by health
maintenance organizations under which the health maintenance organization has
reserved the right to change the schedule of charges for enrollee coverage.
11. a. Notwithstanding any provision of law to the contrary, the School Employees’ 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 benefits under the contract for expenses incurred for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
12. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall ensure the provision of benefits for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill) to eligible persons under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
c. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this section and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
13. a. The State Health Benefits Commission shall provide benefits to each person covered under the State Health Benefits Program for expenses incurred for HIV testing required pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. The benefits provided under this section shall be provided to the same extent as for any other medical condition under the contract.
14. The Commissioner of Health may adopt rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.
15. This act shall take effect immediately.
STATEMENT
This bill establishes and requires coverage for routine opt-out HIV testing during the provision of medical care in certain settings.
HIV (human immunodeficiency virus) is a virus that attacks the body's immune system that without treatment can lead to AIDS (acquired immunodeficiency syndrome). There is currently no effective cure and once people get HIV, they have it for life, but proper medical care can control the virus. Testing for HIV is the only way to determine if a person is living with the virus. If individuals do not know their HIV status, HIV transmission cannot be eliminated. The Centers for Disease Control and Prevention (CDC) recommend that every person between the ages of 13 and 64 years old receive an HIV test at least once, regardless of risk. It is the sponsor’s intent that establishing routine HIV testing in the State will promote early detection and treatment of HIV, reduce transmission of HIV by increasing individual awareness of HIV status, and align with CDC recommendations for HIV screening.
The bill provides that, as a part of routine medical care involving the collection of specimen from a patient for laboratory examination, HIV testing will be included for patients receiving care in the following settings: primary care settings; emergency departments of licensed general hospitals in this State; and any other appropriate health care setting as determined by the Commissioner of Health. Under the bill, separate written consent for HIV testing will not be required when a patient, or the patient’s parent or legal guardian as applicable, has already provided general consent for medical care. Each patient will be tested for HIV, unless:
1) the patient, or the patient’s parent or legal guardian as applicable, opts out of the testing;
2) if the patient is an adult, the patient lacks decision-making capacity;
3) the patient requires emergency care that prevents the testing from occurring;
4) the patient is receiving hospice care through a licensed hospice; or
5) the patient already has a confirmed diagnosis of HIV. Testing of a patient for HIV will be voluntary and free of coercion. The provision of pre-test counseling will not be required prior to HIV testing. The patient will be notified that testing will be performed unless the patient, or the patient’s parent or legal guardian as applicable, declines the testing. The health care provider performing the test will maintain documentation consistent with any applicable federal and State HIV clinical practice guidelines concerning medical record documentation. If a patient declines to be tested for HIV, the declination shall be documented in the patient’s medical record.
The bill requires the Commissioner of Health to establish guidelines regarding: health care providers providing timely notification to a patient, or the patient’s parent or legal guardian as applicable, whose test result is positive, counseling about the significance of the test result, providing referrals to appropriate follow-up care, and coordinating with the Department of Health as necessary; and a model notice for providers to use when informing patients of the HIV test.
Under the bill, health insurance carriers in the State will be required to cover the routine HIV testing required under the bill.