This bill (A-2540, "Cancer Patient Care and Compassion Act") requires health insurance plans and Medicaid in New Jersey to cover specific cancer treatments without cost-sharing for patients with Stage III, IV, or terminal cancer. It mandates coverage for parenteral treatments (like IV medications), survivorship care plans, and other services determined by regulators. The bill also adds protections: mortgage lenders must pause foreclosure during active treatment, creditors cannot initiate collections, and tenants facing eviction can request a 45-day stay with physician certification. These provisions directly affect cancer patients and their families by removing financial barriers to care and preventing housing/financial instability during treatment. The bill is pending before the Assembly Financial Institutions and Insurance Committee.
This bill prohibits New Jersey health insurance carriers from reducing reimbursement rates for network providers during the term of existing contracts. It directly affects insurance companies and healthcare providers who have signed contracts with these insurers. The key provision prevents carriers from unilaterally lowering payments to providers for the duration of their agreements. The law takes effect on the first day of the third month following enactment and applies to all new or renewed contracts after that date.
This New Jersey bill (A 453) limits out-of-pocket costs for asthma inhalers under most health insurance plans. It requires coverage for prescribed asthma inhalers with no deductible and caps copayments or coinsurance at $35 per 30-day supply. The law applies to hospital, medical, and health service corporation plans issued or renewed in New Jersey, directly affecting asthma patients covered by these plans. Plans may lower costs further but cannot exceed this $35 limit per month.
This bill requires health insurance companies in New Jersey to provide policyholders with a written copy of any verbal agreement about coverage within 30 days of the agreement. It applies to all health insurance carriers (including HMOs and dental plans) and covers initial coverage, changes to coverage, or claim reimbursements discussed orally. The written copy must comply with existing insurance simplification rules, and policyholders gain the right to request recordings or transcripts of the verbal agreement. Policyholders also have 30 days after receiving the written copy to report any discrepancies between it and the original oral discussion.
This bill requires all health insurance plans in New Jersey to cover continuous glucose monitoring systems prescribed for treating glycogen storage disease, a rare metabolic condition. It applies to hospital service corporations, medical service corporations, health service corporations, individual health insurance policies, group health plans, and health benefits plans. The coverage must be provided at the same level as for other medical conditions, eliminating insurance denials for this specific treatment. This directly affects patients with glycogen storage disease and their insurers, ensuring access to necessary monitoring technology without extra cost barriers.
This New Jersey bill requires hospitals providing breast cancer surgical treatments (like mastectomy or lumpectomy) to give patients written notice at diagnosis - before surgery consent - about their rights to consult with any board-certified plastic surgeon (regardless of hospital or insurance network) and coverage for reconstructive surgery under state/federal law. It also prohibits health insurance contracts from blocking doctors from recommending plastic surgeons outside their network or denying reconstructive surgery coverage based solely on a surgeon’s network status. The policy applies specifically to patients undergoing treatment for breast cancer, breast cancer genes, or other breast abnormalities. Hospitals must provide this notice upon diagnosis, ensuring patients understand their options for reconstruction and coverage.
S 3502 requires all health insurance plans and Medicaid in New Jersey to cover stuttering treatment, including both habilitative (helping learn or maintain speech skills) and rehabilitative (restoring lost speech skills) speech therapy. It mandates coverage for in-person and telehealth services without cost-sharing like deductibles, copays, or annual limits, and eliminates prior authorization requirements. This directly affects all New Jersey residents with health insurance or Medicaid who need speech therapy for stuttering. The bill applies to all relevant insurance contracts issued in the state, ensuring consistent coverage for medically necessary stuttering treatment.
This bill requires health insurers in New Jersey to maintain coverage for prescription drugs for individuals with complex/chronic medical conditions or rare diseases during any appeal stage if coverage was previously denied based on medical necessity. It prevents insurers from imposing new cost increases, coverage limits, or moving drugs to higher-cost tiers while an appeal is pending. Insurers may only deny coverage during an appeal if the prescribing doctor stops recommending the drug, the FDA issues a safety warning, or the drug manufacturer discontinues production. The law applies to all group and individual health insurance plans sold in New Jersey that cover prescription drugs.
This bill (A 3432) requires health insurance plans in New Jersey (both hospital and medical service corporation contracts) to cover specific preventive services without cost-sharing. It mandates coverage for USPSTF "A"/"B" rated services, CDC-recommended immunizations, pediatric care guidelines, and women's preventive services, with coverage required at least once per calendar year (not policy year). Plans must cover out-of-network services when no in-network provider is available for covered services, and coverage begins one year after a new recommendation is issued. The bill affects all applicable insurance contracts issued or renewed in New Jersey, ensuring broader access to preventive care without patient cost-sharing for these specific services. (Note: The bill was withdrawn after being approved as P.L.2025, c.386.)
This bill (A 249) prohibits health insurers, pharmacy benefits managers, and state health programs (like the State Health Benefits Program) from requiring pre-approval or precertification for covered medical tests, procedures, or prescription drugs. It applies when a licensed healthcare provider prescribes the service or drug, and it is already covered under the health or prescription drug plan. The law directly affects patients seeking covered care by removing bureaucratic delays caused by insurance company review processes. Key provisions eliminate requirements for prior authorization on covered services, ensuring payment is processed without insurer-imposed delays. The bill takes effect immediately for plans issued or purchased on or after the effective date.
