NJ S1554

Mandates out-of-network coverage for children diagnosed with catastrophic illnesses, defined as acute or prolonged illnesses that are life-threatening or pose risk of serious residual disability

Requires coverage when an in-network provider refers the child to an out-of-network provider for treatment

Out-of-network benefits must be provided at the same level as in-network coverage for the same services

Applies to hospital service corporations, medical service corporations, health service corporations, HMOs, individual and small employer health plans, the State Health Benefits Program, and NJ FamilyCare

Takes effect 90 days after enactment and is named for Breann LaManna, a New Jersey child who was denied out-of-network coverage for a life-threatening illness