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THE MANDATED HEALTH BENEFITS ADVISORY COMMISSION IS THE RECIPIENT AND SOLE DISTRIBUTOR OF THE ATTACHED INFORMATION. THE INFORMATION YOU PROVIDE BELOW WILL ASSIST THE COMMISSION IN ITS ANALYSIS OF THE SOCIAL AND FINANCIAL IMPACT AND MEDICAL EFFICACY OF THE PROPOSED MANDATED HEALTH BENEFIT.

IMPORTANT

GENERAL INSTRUCTIONS: It is essential that all information provided is complete and all sections that apply are answered. DO NOT LEAVE ANY SECTION UNANSWERED. IF ADDITIONAL SPACE IS REQUIRED, PLEASE USE THE REMARKS SECTION AT THE END OF THE FORM.

The form should be completed and submitted directly to the New Jersey Mandated Health Benefits Advisory Commission either by sending it as an e-mail attachment to MHBAC@dobi.nj.gov or by mailing it to the Commission at PO Box 325, Trenton, Sexy真人 08625.

If you have any questions concerning the completion of the application, contact us at 609-292-3100 or by e-mail at MHBAC@dobi.nj.gov

PROPOSED MANDATED HEALTH BENEFIT: ____________________________________

BILL NUMBER: ____________________________________

BILL SPONSOR: ____________________________________

A.) INFORMATION ON SOCIAL IMPACT SHOULD INCLUDE BUT NOT BE LIMITED TO:

1. the extent to which the proposed mandated health benefit and the services it would provide are needed by, available to and utilized by the population of New Jersey;
2. the extent to which the proposed mandated health benefit already exists or, if no coverage exists, the extent to which the lack of coverage results in inadequate health care or financial hardship for the affected population of New Jersey;
3. the demand for the proposed mandated health benefit from the public and the source and extent of opposition to mandating the health benefit;
4. relevant findings bearing on the social impact of the lack of the proposed mandated benefit; and
5. such other information with respect to the social impact that would aid the Commission in analyzing this information.

B.) INFORMATION ON FINANCIAL IMPACT SHOULD INCLUDE BUT NOT BE LIMITED TO:

1. the extent to which the proposed mandated benefit would increase or decrease the cost for treatment or service;
2. the extent to which similar mandated health benefits in other states have affected charges, costs and payments for services;
3. the extent to which the proposed mandated health benefit would increase the appropriate use of the treatment or service;
4. the impact of the proposed mandated health benefit on the total costs to carriers and on administrative costs;
5. the impact of the cost of the proposed mandated health benefit on total costs to purchasers and benefit costs;
6. the impact of the proposed mandated benefit on the total cost of health care within New Jersey; and
7. such other information with respect to the financial impact that would aid the Commission in analyzing this information.

C.) INFORMATION ON THE MEDICAL EFFICACY SHOULD INCLUDE BUT NOT BE LIMITED TO:

1. if the proposed health benefit mandates coverage of a particular treatment or therapy, the recommendation of a clinical study or review article in a major peer-reviewed professional journal;
2. if the proposed health benefit mandates coverage of the services provided by an additional class of practitioners, the results of at least one professionally accepted, controlled trial comparing the medical results achieved by the additional class of practitioners and the practitioners already covered by benefits;
3. the results of other research;
4. the impact of the proposed benefit on the general availability of health benefits coverage in New Jersey; and
5. such other information with respect to the medical efficacy that would aid the Commission in analyzing this information.

D.) INFORMATION ON THE EFFECTS OF BALANCING THE SOCIAL, ECONOMIC AND MEDICAL EFFICACY CONSIDERATIONS SHOULD INCLUDE BUT NOT BE LIMITED TO:

1. the extent to which the need for coverage outweighs the costs of mandating the health benefit; and
2. the extent to which the problem of coverage may be solved by mandating the availability of the coverage as an option under a health benefits plan.

E.) INFORMATION COLLECTED FROM VARIOUS SOURCES. INCLUDING, BUT NOT LIMITED TO:

1. a State data collection system;
2. the Department of Health and Senior Services and Banking and Insurance;
3. health planning organizations;
4. proponents and opponents of the proposed health benefit mandate supporting their position; and
5. such other data sources that may be appropriate to aid the Commission in analyzing information form these various sources.

F.) ADDITIONAL REMARKS: