NJ S1922

"Breann's Law" mandates that health insurers cover out-of-network healthcare services for children diagnosed with catastrophic illnesses at the same rate as in-network benefits, when referred by an in-network provider

Catastrophic illness is defined as an acute or prolonged illness considered life-threatening or carrying the threat of serious residual disability

Coverage requirements apply to hospital service corporations, medical service corporations, health service corporations, group and individual health insurance policies, small employer health plans, and HMOs

The State Health Benefits Program (SHBP) and NJ FamilyCare must also provide these out-of-network benefits for children with catastrophic illnesses

Named after Breann LaManna, a New Jersey child who was denied out-of-network coverage for a life-threatening illness; takes effect 90 days after enactment