N.J. Admin. Code § 11:24A-2.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:24A-2.6 - Emergency and urgent care services

(a) If a carrier's policy or contract provides benefits for emergency or urgent care services, the carrier shall include benefits for the coverage of trauma services at any designated Level I or II trauma center as medically necessary, which shall be continued at least until, in the judgment of the attending physician, the covered person is medically stable, no longer requires critical care, and can be transferred safely to another facility.

(b) In addition to (a) above, the contract or policy shall pay for coverage of a medical screening examination provided upon a covered person's arrival in a hospital, as required to be performed by the hospital in accordance with Federal law and as specified at N.J.A.C. 8:43G-12, but only as necessary to determine whether an emergency medical condition exists.