A 5571 New Jersey General Assembly · 2024-2025 Regular Session

Prohibits pre-approval or precertification of medical tests, procedures and prescription drugs covered under health benefits or prescription drug benefits plans.

This bill prohibits health insurance companies, pharmacy benefit managers, and state health programs from requiring pre-approval or precertification for medical tests, procedures, or prescription drugs that are already covered under a health plan and prescribed by a licensed doctor. It directly affects patients and healthcare providers by eliminating bureaucratic delays that currently delay care - such as cancer patients waiting for medication due to slow insurance reviews. The law requires insurers to pay for covered services as prescribed, without additional approval steps. It applies immediately to all health plans issued or purchased on or after the effective date.
Bill status in committee 1 of 4 stages cleared
Introduction
Apr 2025
Committee Review
Floor Vote
Governor
Introduced Apr 10, 2025 Last action Apr 10, 2025
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Apr 10, 2025
Introduced
Introduced in the Assembly, Referred to Assembly Financial Institutions and Insurance Committee
lower
2 primary · 1 co-sponsor

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