§ 17:48A-1 Definitions; liability for medical services
§ 17:48A-2 Nonprofit corporation; trustees and physicians; who may operate medical service plan; certificate of authority
§ 17:48A-2.1 Medical service corporation merger procedure
§ 17:48A-3 Issuance of certificate of authority; amendment; counties affected
§ 17:48A-4 Corporate funds required
§ 17:48A-5 Subscription contracts
§ 17:48A-6 Written contracts required; subscription certificates
§ 17:48A-6.1 Elective surgery; definitions
§ 17:48A-6.2 Second surgical opinion program
§ 17:48A-6.3 Payment for second surgical opinion
§ 17:48A-6.4 Third surgical opinion
§ 17:48A-6.5 Second opinion exclusions
§ 17:48A-6.6 Physicians furnishing opinion and performing surgical procedure; payment
§ 17:48A-6.7 Application
§ 17:48A-6.10 Eligibility for enrollment in medical service corporation
§ 17:48A-6.11 Medical service corporation contract, exclusion, rates, terms based on genetic information prohibited
§ 17:48A-7 Formal requirements for subscription certificates
§ 17:48A-7b Reconstructive breast surgery; benefits
§ 17:48A-7c Medical service contracts
§ 17:48A-7d Medical service corporation insurance benefits for preexisting condition
§ 17:48A-7e Medical service corporation to pay benefits for treatment of Wilm’s tumor
§ 17:48A-7f Medical service corporation contract, mammogram examination benefits
§ 17:48A-7g Medical service corporation, benefits for “off-label” drugs required
§ 17:48A-7h Medical service corporation, benefits for health promotion
§ 17:48A-7i Requirements for medical service corporation providing benefits for pharmacy services
§ 17:48A-7j Benefits for certain cancer treatments
§ 17:48A-7k Coverage for birth and natal care; medical service corporation
§ 17:48A-7l Coverage for diabetes treatment by individual, group medical service corporation
§ 17:48A-7m Medical service corporation contract, Pap smear benefits
§ 17:48A-7mm Medical service corporation contract to cover digital tomosynthesis of the breast
§ 17:48A-7n Medical service corporation contract, prostate cancer testing
§ 17:48A-7nn Medical service corporation to provide coverage for donated human breast milk
§ 17:48A-7o Coverage for minimum inpatient care following mastectomy by individual, group medical service corporation
§ 17:48A-7p Applicability of Health Care Quality Act
§ 17:48A-7q Coverage for treatment of inherited metabolic diseases by medical service corporation
§ 17:48A-7r Medical service corporation to cover certain audiology, speech-language pathology services
§ 17:48A-7s Coverage for treatment of domestic violence injuries by medical service corporation
§ 17:48A-7t Coverage for certain dental procedures for the severely disabled or child age five or under by medical service corporation
§ 17:48A-7u Medical service corporation to provide coverage for mental health conditions, substance use disorders; collaborative care model
§ 17:48A-7v Coverage for hemophilia services by medical services corporation
§ 17:48A-7w Medical service corporation to provide coverage for treatment of infertility
§ 17:48A-7x Medical service corporation to provide coverage for colorectal cancer screening
§ 17:48A-7x v2 Medical service corporation to provide coverage for colorectal cancer screening
§ 17:48A-7y Medical service corporation prescription drug plans to cover certain infant formulas
§ 17:48A-7z Contract issued under C.17:48A-1 et seq. required to cover certain out-of-network services
§ 17:48A-7aa Medical service corporation to offer coverage for domestic partner
§ 17:48A-7bb Medical service corporation, coverage for contraceptives
§ 17:48A-7cc Medical service corporation to provide benefits for orthotic and prosthetic appliances
§ 17:48A-7dd Medical service corporation to provide coverage for hearing aids for certain persons aged 15 or younger
§ 17:48A-7ee Individual, group medical service corporation to provide installment payments to obstetrical provider for maternity services
§ 17:48A-7ff Medical service corporation to provide benefits for treatment of autism or other developmental disability
§ 17:48A-7gg Medical service corporation to provide coverage for oral anticancer medications
§ 17:48A-7hh Medical service corporation to provide coverage for sickle cell anemia
§ 17:48A-7ii Medical service corporation to provide coverage for prescription eye drops
§ 17:48A-7jj Medical service corporation contract, coverage for synchronization of prescribed medications
§ 17:48A-7kk Medical service corporation to provide benefits for treatment of substance use disorder
§ 17:48A-7ll Medical service corporation to provide coverage regardless of gender identity, expression
§ 17:48A-7oo Medical service corporation to provide coverage for standard fertility preservation services
§ 17:48A-7pp Medical service corporation to provide coverage for breastfeeding support
§ 17:48A-7qq Medical service corporation to cover preventive services
§ 17:48A-7rr Medical service corporation to provide certain coverage for prescription drugs
§ 17:48A-7ss Medical service corporation to cover adolescent depression screenings
§ 17:48A-7tt Medical service corporation to cover newborn home nurse visitation
§ 17:48A-7.1 Group contracts; issuance; description; benefits; employees defined
§ 17:48A-7.2 Provisions applicable to group contracts
§ 17:48A-7.3 Group contract form
§ 17:48A-7.4 Participation agreements
§ 17:48A-7.5 Schedule of rates
§ 17:48A-7.6 Combined hospital-medical contract
§ 17:48A-7.7 Review of determinations of commissioner of banking and insurance
§ 17:48A-7.8 Review of practices, rules and procedures of medical service corporations
§ 17:48A-7.9 Adjustment of rates; experience rating formula; approval
§ 17:48A-7.10 Coverage provided by medical service corporation for subscriber’s child
§ 17:48A-7.11 Requirements applicable to State Medicaid
§ 17:48A-7.12 Medical service corporation to receive, transmit transactions electronically; standards
§ 17:48A-7.13 Coverage for certain dependents until age 31 by medical service corporation
§ 17:48A-8 Participating physicians; payments for medical services
§ 17:48A-9 Filing form of subscription certificate, etc.; disapproval by commissioner
§ 17:48A-9.1 Medical service corporation contract; compliance
§ 17:48A-9.2 Filing of contract or related forms
§ 17:48A-9.3 Contract forms; certification memorandum
§ 17:48A-10 Schedule of rates; filing, disapproval
§ 17:48A-11 Agreements with physicians; approval of payments; corporate records
§ 17:48A-12 Expenditures in soliciting subscribers
§ 17:48A-13 Administrative expenses
§ 17:48A-13.1 Medical service corporation, aggregate benefits
§ 17:48A-14 Investments; surplus
§ 17:48A-15 Statement of financial condition; inquiries by commissioner
§ 17:48A-16 Failure to file statement or answer inquiries; penalty
§ 17:48A-17 Examination of assets and affairs; assistants
§ 17:48A-18 Expense of examination; gifts, etc., to departmental employees
§ 17:48A-19 Exhibition of records and accounts; examinations under oath
§ 17:48A-19.1 Definitions
§ 17:48A-19.2 Increase in amount of capital or surplus required of medical service corporation
§ 17:48A-19.3 Determination of increase, revision or redetermination; factors
§ 17:48A-19.4 Suspension, revocation of authority to do business
§ 17:48A-19.5 Rules, regulations
§ 17:48A-21 Fees
§ 17:48A-22 Violations of chapter; penalty and recovery thereof; misdemeanors
§ 17:48A-23 Grants for needy persons
§ 17:48A-24 Corporation as charitable and benevolent institution; tax exemption
§ 17:48A-25 Partial invalidity
§ 17:48A-26 Podiatrist, services performed by
§ 17:48A-27 Bio-analytical laboratory, services performed by
§ 17:48A-28 Dentists, services performed by
§ 17:48A-28.1 Policies providing for reimbursement of services of dentist; additional applicable provisions
§ 17:48A-28.2 Application of act to contracts with reservation of right to change premium
§ 17:48A-29 Optometrist, services performed by
§ 17:48A-30 Psychologist, services performed by
§ 17:48A-31 Physical therapist, services performed by
§ 17:48A-32 Chiropractors; authorization for payment for diagnostic X-rays; inclusion in act as physician licensed to practice medicine or surgery; liberal construction
§ 17:48A-33 Chiropractors, services performed by
§ 17:48A-34 Nurse-midwives, services performed by
§ 17:48A-35 Services provided by registered professional nurse; benefits

Terms Used In New Jersey Statutes > Title 17 > Chapter 48A

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Donor: The person who makes a gift.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fraud: Intentional deception resulting in injury to another.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • month: means a calendar month, and the word "year" means a calendar year. See New Jersey Statutes 1:1-2
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
  • State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • sworn: includes "affirmed. See New Jersey Statutes 1:1-2
  • Trustee: A person or institution holding and administering property in trust.
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.