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 (Note: The bill was withdrawn after being approved as P.L.2025, c.386.)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.
This bill requires New Jersey health insurance companies to cover mental health treatment and therapy for victims of domestic violence as "medically necessary," eliminating insurance denials for these services. It directly affects insurance carriers (who must provide full coverage) and domestic violence victims (who gain guaranteed access to mental health care). The key provision mandates that such treatment be covered "to the same extent as any other medically necessary treatment" under a policy, removing barriers insurers previously used to limit coverage. The bill amends multiple insurance law sections to enforce this requirement, applying to all health insurance contracts.
This bill requires all health insurance plans in New Jersey that cover prostheses to include coverage for hair headpieces (human or artificial) worn to conceal scalp hair loss caused by chemotherapy for cancer patients. It applies to hospital service corporations, medical service corporations, health service corporations, individual policies, group policies, and health benefits plans. Coverage is mandatory only when a treating physician provides a written recommendation that the headpiece is medically necessary, and it must follow the same limitations as other prostheses under the plan. The law affects cancer patients undergoing chemotherapy who rely on insurance for these headpieces, ensuring they are covered under existing prosthetic coverage rules.
This New Jersey bill (A2483) requires health insurance plans to cover scalp cooling systems used during cancer chemotherapy to prevent hair loss. It applies to all major insurance types in the state - hospital service contracts, medical service contracts, individual policies, group plans, and health benefits plans - that already cover chemotherapy. Insurers must provide this coverage "to the same extent as for any other condition" under the policy, without additional patient cost. The bill directly affects cancer patients receiving chemotherapy who may use scalp cooling devices, ensuring these treatments are covered as part of standard medical benefits.
This New Jersey bill (A 1509) creates a binding arbitration process for disputes between health insurance companies (carriers) and healthcare providers (like doctors' offices or clinics) over payment rates. If negotiations fail, either party can trigger arbitration by submitting their final payment offer to the state Department of Banking and Insurance, with the arbitrator selecting one of the two offers. The bill requires carriers to notify patients 30 days before open enrollment if a provider will be out-of-network starting the next plan year, while ensuring continued in-network coverage and reimbursement until the new plan year begins. It directly affects health insurers, healthcare providers, and patients who rely on these networks for coverage.
This bill requires New Jersey health insurance carriers to offer "clear cost share plans" for individual health insurance plans. These standardized plans would feature transparent, consistent copayments, coinsurance, and deductibles for covered services across bronze, silver, and gold metal tiers (as defined by federal law). The commissioner of Banking and Insurance must develop these plans, focusing on reducing out-of-pocket barriers and making plan comparisons clearer for consumers. It applies to individual health plans issued on or after January 1, 2023, and allows carriers to offer up to three modified plans with commissioner approval.
This New Jersey bill (A 2452) establishes a constitutional right to access abortion care, including termination of pregnancy, and requires health insurance plans to cover abortion services without cost-sharing (like deductibles or copays). It repeals conflicting state regulations that previously restricted abortion coverage in health plans and state-funded programs. The bill appropriates $20 million to support reproductive health services and defines key terms like "medical abortion" and "practical support" (e.g., transportation, lodging for care access). It directly affects residents seeking abortion care, health insurers, and state agencies administering health programs.
