NJ S3331

Mandates health insurance carriers in New Jersey provide coverage for medical services, procedures, testing, nursing care, equipment, and prescription drugs for individuals 18 years or younger with diagnosed complex medical needs when deemed medically necessary by a licensed health care provider

Requires carriers to approve benefits within three days of receiving a letter from the attending health care provider for patients with complex medical needs

Prohibits carriers from requiring pre-approval or precertification for covered services prescribed by a licensed provider for children with complex medical needs

Defines "complex medical needs" as conditions that are emergent, persistent, substantially disabling, or life-threatening; require specialized skills to prevent serious adverse outcomes; or necessitate anesthesia beyond local anesthesia

Applies to all health insurance companies, health service corporations, HMOs, and entities administering the State Health Benefits Program or School Employees' Health Benefits Program