Healthcare (Insurance)

in committee · New Jersey · General Assembly Jan 13, 2026

A 503: "Consumer Freedom From Unwanted Expense in Health Insurance Coverage Act."

This bill (A 503) allows New Jersey residents to purchase health insurance policies sold by insurers licensed in other states ("foreign health insurers"). It directly affects New Jersey residents (defined as those living in the state for at least six months annually) and their employers, who may reimburse employees for these out-of-state policies. Key provisions require that such purchases satisfy any legal requirement for health insurance coverage, and employers may cover the costs of these policies. The bill takes effect 90 days after enactment, expanding insurance purchasing options beyond New Jersey’s regulated market.

Topics ✓ HealthcareSupports HealthcareExpands health insurance access by permitting out-of-state policies, reducing costs for residents and employers, aligning with improved patient access indicators.85% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 2775: Requires health insurers, SHBP, and SEHBP to cover mammograms for women over 35 and women under 35 under certain circumstances.

This bill requires health insurers, the State Health Benefits Program (SHBP), and the State Employees Health Benefits Program (SEHBP) to cover specific mammogram screenings. It mandates one baseline mammogram for women aged 35 and annual screenings for women 35 and older, while also requiring coverage for women under 35 with breast cancer risk factors (like family history) as determined by their provider. Additional tests like ultrasounds or MRIs are covered if needed due to dense breast tissue, abnormal results, or other risk factors. The law applies to all health insurance plans in New Jersey, ensuring these screenings are covered without additional out-of-pocket costs for eligible individuals.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover mammograms for specified groups, expanding preventive care access and aligning with coverage expansion indicators.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentMandates mammogram coverage under state health programs, expanding employee health benefits for workers in SEHBP.85% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 3128: Requires health insurance coverage of diagnostic and supplemental breast examinations without cost-sharing.

New Jersey bill A3128 requires all health insurance plans sold in the state to cover diagnostic and supplemental breast examinations with no out-of-pocket costs to patients. It applies to group and individual health insurance contracts, mandating that insurers pay for these exams without deductibles, copays, or coinsurance. Diagnostic exams evaluate abnormalities found during screenings or detected another way, while supplemental exams screen high-risk patients (e.g., those with dense breasts or family history) when no abnormality is present. The law aligns with National Comprehensive Cancer Network Guidelines and applies to all plans except those specifically structured as medical savings accounts under federal law. This directly affects all New Jersey residents with health insurance who may need these breast exams.

Topics ✓ HealthcareSupports HealthcareMandates no cost-sharing for breast exams, expanding insurance coverage and improving patient access to preventive care as per bill summary.95% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · General Assembly Feb 19, 2026

A 4438: Requires health insurance coverage of prenatal genetic test during first trimester of pregnancy.

This bill requires all health insurance plans in New Jersey to cover specific prenatal genetic tests during the first trimester of pregnancy. It applies to hospital service, medical service, health service, individual, and group insurance policies issued in the state. Covered tests include carrier screening (a blood or cheek swab test for inherited disorders), nuchal translucency screening, and chorionic villus sampling. Insurance plans must provide this coverage at the same level as other medical conditions, meaning no additional out-of-pocket costs for patients beyond standard coverage.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for prenatal genetic tests, expanding access to essential healthcare services without cost-sharing.95% confidence

Sub-Topics Hospitals Insurance

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 996: Requires health insurers to provide coverage for testing for suspected dyslexia.

This bill requires all health insurance plans in New Jersey (including individual, group, and small employer plans) to cover comprehensive neuropsychological testing for suspected dyslexia. It mandates that insurers cannot exclude this coverage, ensuring testing for diagnosis and related psychological/emotional assessments is provided at the same level as other medical conditions. The law applies to all covered health insurance contracts issued or renewed in New Jersey after its effective date, directly affecting patients seeking dyslexia evaluations and insurers offering these plans. It does not create new funding but requires existing insurance policies to include this specific service. The bill is currently pending before the Assembly Financial Institutions and Insurance Committee.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for dyslexia testing, expanding access to diagnostic services under health insurance requirements95% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 2201: Authorizes health care professionals to engage in the use of remote patient monitoring devices; requires health care insurance coverage by certain insurers for remote patient monitoring devices.

This New Jersey bill (A-2201) requires health insurance companies to cover remote patient monitoring devices - like those tracking vital signs - from patients' homes on the same terms as in-person medical visits. It mandates that insurers pay the same reimbursement rate for remote monitoring as they would for in-person care and cannot charge higher deductibles, copays, or coinsurance for these services. The law also prohibits insurers from restricting how providers use technology (e.g., audio-only calls) or limiting coverage for routine remote check-ins, as long as care standards match in-person services. This directly affects health insurers, patients using remote monitoring, and healthcare providers delivering these services in New Jersey.

Topics ✓ HealthcareSupports HealthcareMandates insurers cover remote monitoring devices at same rate as in-person visits, expanding patient access without higher costs or restrictions.95% confidence ✓ TechnologySupports TechnologyMandates insurance coverage for remote patient monitoring devices, requires equal reimbursement, and prohibits restrictions on technology use, advancing healthcare technology adoption.90% confidence

Sub-Topics Insurance Telehealth

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 2604: Requires private health insurers, SHBP, SEHBP, Medicaid, and NJ FamilyCare to cover wigs under certain circumstances.

This bill requires private health insurers, the State Health Benefits Program (SHBP), State Employees Health Benefits Program (SEHBP), Medicaid, and NJ FamilyCare to cover the cost of wigs when prescribed by a dermatologist, oncologist, or physician for medical reasons. Insurers must cover wigs as "durable medical equipment" for subscribers diagnosed with illness, chronic conditions, or injury, provided the doctor certifies medical necessity. Coverage is limited to once every 36 months and cannot be restricted to chemotherapy patients only. The law applies to all health insurance contracts delivered, issued, or renewed in New Jersey after its effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover medically necessary wigs as durable medical equipment, expanding health insurance benefits for patients with qualifying conditions.95% confidence

Sub-Topics Insurance Medicaid

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 998: Directs DHS to establish Children's Partial Hospitalization Pilot Program.

This bill establishes a 36-month pilot program allowing New Jersey's NJ FamilyCare health insurance program to reimburse non-hospital-based partial hospitalization services for children aged 5-14 with mental health needs. It directly affects low-income children requiring intensive outpatient mental health care and providers who can apply to participate. The key provision changes current reimbursement rules - previously requiring services to occur in a hospital - to permit care at non-hospital locations, while maintaining all other federal and state eligibility requirements. The program requires the Department of Human Services to select one provider, monitor outcomes, and report findings to the Governor and Legislature within 36 months of selection.

Topics ✓ HealthcareSupports HealthcareExpands mental health coverage for low-income children by enabling NJ FamilyCare reimbursement for non-hospital partial hospitalization services, improving access to intensive outpatient care.95% confidence

Sub-Topics Hospitals Insurance Mental Health

Track

in committee · New Jersey · General Assembly Jun 30, 2026

A 4357: Extends certain pay parity regarding telemedicine and telehealth.*

This bill permanently requires New Jersey health insurance carriers to pay the same reimbursement rate for telemedicine and telehealth services as they do for in-person visits, provided the service is otherwise covered. It ensures patients face no higher deductibles, copays, or coinsurance for telehealth compared to in-person care. The law prohibits insurers from restricting where telehealth services can occur, limiting which technology platforms providers can use, or denying coverage for routine remote monitoring. It directly affects health insurance companies, healthcare providers offering telehealth, and patients receiving covered telehealth services. The policy change applies to all health benefits plans in New Jersey without time limits.

Topics ✓ HealthcareSupports HealthcareRequires equal insurance reimbursement for telehealth vs in-person care, removing financial barriers and expanding access to healthcare services.95% confidence ✓ TechnologySupports TechnologyRequires equal reimbursement for telehealth vs in-person care, prohibits insurer restrictions on technology platforms, enabling broader adoption of telehealth technology.95% confidence

Sub-Topics Insurance Telehealth

Track

in committee · New Jersey · General Assembly Jan 13, 2026

A 3284: Requires 90 days' notice of cancellation or nonrenewal of stop loss insurance for small employer health benefits plans.

This bill requires insurers to provide small employers with at least 90 days' written notice before canceling or refusing to renew stop loss insurance policies for their self-funded health plans. Stop loss insurance protects small employers from unexpectedly high medical costs for their employees' health coverage. The notice must be in a format set by New Jersey's Banking and Insurance Commissioner and applies to policies issued or renewed 90 days after the law takes effect. This directly affects small business health plan sponsors who rely on this coverage to manage financial risk.

Topics ✓ HealthcareSupports HealthcareRequires 90-day notice for stop loss insurance cancellations, protecting small employers' stable health coverage and preventing abrupt disruptions in employee health benefits.90% confidence

Sub-Topics Insurance

Track