S 374 New Jersey Senate · 2026-2027 Regular Session

Requires health benefits coverage for treatment of lipedema.

This bill requires health insurance plans in New Jersey to cover specific treatments for lipedema, a chronic fat disorder. It mandates coverage for compression garments, manual lymphatic drainage, medical nutrition therapy, mental health care, and medically necessary lipectomies (including pre- and post-surgery appointments). Insurers must base coverage decisions on physician diagnoses and surgeon documentation (including photos for lipectomies), cannot deny coverage solely based on photos, and must honor prior authorizations for lipectomies for one year. The coverage must match the same deductibles, coinsurance, and standards of care as other similar medical treatments. This directly affects insured residents diagnosed with lipedema and their health insurance providers.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2026

Committee Review

Floor Vote

Governor

Introduced Jan 13, 2026 Last action May 18, 2026

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What changed between versions

Introduced → Reprint · 3 edits

MINOR

The Senate Commerce Committee reported S374 with amendments that significantly weakened the prior authorization protections for lipedema lipectomy coverage. The original bill guaranteed a one-year validity period for prior authorizations, prohibited carriers from revoking or restricting them within that window, and required new carriers to honor authorizations from previous carriers. The amendment replaces all of these specific protections with a general reference to the existing 'Ensuring Transparency in Prior Authorization Act' (P.L.2023, c.296), leaving patients subject to whatever rules that law establishes rather than the stronger guarantees originally proposed.

REQUIREMENT

Subsection d across all covered entity types (hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, individual and small employer health benefits plans, HMOs, and State/School Employees Health Benefits Program contracts) was amended to remove the specific one-year prior authorization validity period, the prohibition on revocation or restriction within that period, and the requirement to honor prior authorizations from previous carriers. These were replaced with a single reference stating prior authorization shall be in accordance with requirements under the Ensuring Transparency in Prior Authorization Act (C.17B:30-55.1 et seq.).

TECHNICAL

The entire explanatory STATEMENT section at the end of the bill was removed, which had described the original provisions including the one-year prior authorization validity and portability requirements.

Header updated from 'Introduced Pending Technical Review' to 'As reported by the Senate Commerce Committee on May 18, 2026, with amendments,' and bill designation changed to S374 1R (First Reprint).

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Full legislative history

Actions timeline

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Key actions

Committee

May 18, 2026

Committee

Referred to Senate Budget and Appropriations Committee

upper

Jan 13, 2026

Introduced

Introduced in the Senate, Referred to Senate Commerce Committee

upper

2 primary · 0 co-sponsors