New Jersey 2024-2025 Regular Session

New Jersey Assembly Bill A5052

Introduced
12/9/24  
Refer
12/9/24  
Refer
12/11/25  
Report Pass
12/18/25  
Engrossed
12/22/25  
Enrolled
1/12/26  
Chaptered
1/20/26  

Caption

Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

Impact

The enactment of AB 5052 is poised to significantly impact the coverage landscape for behavioral health services in New Jersey. By mandating that all health insurers and Medicaid programs provide benefits for these crucial services to any covered person, the bill promotes equity in healthcare access. This change is particularly important as it allows for the reimbursement of preventive services and screenings that previously may not have been covered, therefore addressing gaps in behavioral health services for children across the state.

Summary

Assembly Bill 5052 introduces requirements for health insurance and Medicaid programs in New Jersey to cover screening, prevention, and treatment services for behavioral health issues specifically affecting children. The bill delineates that health carriers must accept and reimburse claims made under an 'at-risk diagnosis.' This diagnosis considers various influencing factors such as family circumstances and life challenges, promoting preventive care without necessitating formal mental health diagnoses. This approach aims to facilitate early identification and intervention for mental health conditions in children, enhancing overall healthcare provision in the state.

Contention

Notable points of contention surrounding AB 5052 relate to the definitions and scope of 'at-risk diagnosis.' Critics may raise concerns about the potential for misuse of this categorization or the breadth of services covered under this designation. Supporters, however, argue that the bill represents a significant advancement in how mental health issues in children are approached, focusing on preventive care and ensuring that families can access the necessary services before conditions escalate into more serious mental health crises. The ability for providers to use alternative coding for billing purposes also poses questions about standardization and potential impacts on insurance claims processing.

Companion Bills

NJ S4018

Same As Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

Previously Filed As

NJ A2749

Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

NJ S3008

Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

NJ HB1578

Health insurance and Medicaid; require coverage for postpartum depression screenings.

NJ S3549

Requires health insurance coverage for certain obesity treatments.

NJ SB244

Revise laws related to health insurance coverage of behavioral health screening

NJ HB2097

Health insurance; coverage requirements for prostate cancer screenings.

NJ SB1314

Health insurance; coverage requirements for prostate cancer screenings.

NJ A3745

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

NJ S722

Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

NJ S3502

Requires health insurance and Medicaid coverage for treatment of stuttering.

Similar Bills

NJ S3008

Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

NJ A2749

Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

HI HR138

Urging The Prohibition Of The Use Of "excited Delirium", Or Similar Pseudoscientific Concepts, As A Medical Diagnosis, Cause Of Death, Or Legal Theory In The State Of Hawaii.

HI HCR146

Urging The Prohibition Of The Use Of "excited Delirium", Or Similar Pseudoscientific Concepts, As A Medical Diagnosis, Cause Of Death, Or Legal Theory In The State Of Hawaii.

CA AB360

Menopause.

LA SB42

Provides relative to perinatal behavioral health treatment. (8/1/25) (EN INCREASE GF EX See Note)

RI S0103

Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of diagnosing and treating infertility, for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with IVF.

MS SB2404

Cancer coverage under First Responders Health and Safety Act; extend eligibility.