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Bill

A 5133

Requires health insurance and Medicaid coverage for the treatment of stuttering.

2024-2025 Regular Session Introduced by Bob Auth and 19 co-sponsors

Bill A 5133 mandates health insurance and Medicaid in New Jersey to cover stuttering treatment, ensuring access to speech therapy without financial barriers.

Reported out of Assembly Committee with Amendments and Referred to Assembly Health Committee
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Bill Summary · A 5133

Summary of Bill A 5133: Health Insurance and Medicaid Coverage for Stuttering Treatment

Purpose and Intent

Bill A 5133 aims to require health insurance and Medicaid coverage for the treatment of stuttering in New Jersey. The legislation seeks to ensure that individuals who stutter have access to necessary medical treatments, including habilitative and rehabilitative speech therapy, without facing financial barriers.

Key Provisions

The bill includes several significant provisions:

  1. Coverage Requirements:

    • Health insurance policies and Medicaid must cover medical expenses related to the treatment of stuttering, including:
      • Habilitative Speech Therapy: Therapy aimed at helping individuals maintain or improve their speech skills.
      • Rehabilitative Speech Therapy: Therapy focused on restoring or improving lost speech skills.

  2. Delivery of Services:

    • Coverage applies to services delivered in-person or via telemedicine/telehealth.

  3. No Prior Authorization:

    • Insurers cannot impose prior authorization or other utilization management requirements for these services.

  4. Cost-Sharing Provisions:

    • No deductibles, coinsurance, copayments, or annual benefit limits can be imposed on the coverage for stuttering treatment, ensuring that patients can access necessary care without additional financial burdens.

  5. Applicability:

    • The provisions apply to various types of health insurance contracts, including:
      • Hospital service corporation contracts
      • Medical service corporation contracts
      • Health service corporation contracts
      • Individual and group health insurance policies

Affected Parties

  • Individuals Who Stutter: The primary beneficiaries of this bill will be individuals diagnosed with stuttering, including children and adults, who will gain access to essential speech therapy services.
  • Healthcare Providers: Speech therapists and medical professionals involved in the treatment of stuttering will be impacted as they will be able to provide services without the constraints of prior authorization or cost-sharing requirements.

Procedural Aspects

  • Introduced: December 16, 2024
  • Current Status: Reported out of the Assembly Financial Institutions and Insurance Committee with amendments on April 10, 2025, and referred to the Assembly Health Committee for further consideration.
  • Sponsorship: The bill is sponsored by Assemblywomen Alixon Collazos-Gill, Andrea Katz, and Shama A. Haider, with multiple cosponsors from various districts.

Related Legislation

  • Companion Bill: S 3558, which addresses similar issues in the Senate.

This legislation represents a significant step towards improving access to necessary healthcare services for individuals who stutter, promoting inclusivity and support for those affected by speech disorders.

Compiled from official sources — confirm details with the bill’s official record.

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