NJ A3093

Hospitals providing breast cancer surgical services must give patients written notice of their right to consult with any board-certified plastic surgeon for reconstructive options, regardless of hospital affiliation or network participation.

Written notice must be provided when the hospital learns of a patient's breast cancer diagnosis and before obtaining consent for surgical procedures, including information about prosthesis options and insurance coverage for reconstruction.

Health insurance carrier contracts with providers cannot include provisions that prohibit or limit referrals to plastic surgeons based on network affiliation when the patient's clinical needs require breast reconstructive services.

Carriers are prohibited from denying medical necessity approval for reconstructive surgery solely based on the plastic surgeon's network status or hospital affiliation.

The law takes effect 90 days after enactment and applies to the State Health Benefits Program, School Employees' Health Benefits Program, and other health carriers.