Healthcare (Insurance)

in committee · New Jersey · Senate May 11, 2026

S 4122: Requires health insurance coverage for coronary artery calcium screening under certain circumstances.

This New Jersey bill requires most private health insurance plans to cover coronary artery calcium screening tests for eligible members. The screening is mandated for individuals aged 45 and older or those identified by a doctor as having an intermediate risk of heart disease based on standard medical calculations. Insurance companies must provide this coverage every five years, though doctors can recommend more frequent tests if a patient has specific underlying health conditions. The rule applies to hospital, medical, and health service corporations as well as individual policies issued or renewed in the state after the law takes effect.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for heart disease screening, expanding access to preventive care and strengthening health services.95% confidence

Sub-Topics Hospitals Insurance

Track

in committee · New Jersey · General Assembly May 7, 2026

A 4916: Requires health insurers to cover colorectal cancer screenings for covered persons aged 33 or over and covered persons under the age of 33 if deemed medically necessary.

This New Jersey bill requires health insurers to cover colorectal cancer screenings for all covered individuals aged 33 and older, as well as for those under 33 if their doctor deems it medically necessary. The law mandates that these screenings follow the most recent guidelines from the United States Preventive Services Task Force and must be provided without any deductibles, copayments, or other out-of-pocket costs. Additionally, the bill ensures that if a non-colonoscopy screening test returns a positive result, the subsequent colonoscopy is also fully covered. These changes apply to various types of health insurance contracts issued or renewed in the state after the act becomes effective.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for colorectal cancer screenings, expanding access and removing out-of-pocket costs for patients.95% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · Senate May 14, 2026

S 4282: "Property Tax Relief Act"; makes various changes to SHBP and SEHBP administration and limits reimbursement for certain medical procedures.

The Property Tax Relief Act modifies how New Jersey's State and School Employees' Health Benefits Programs handle insurance contracts and employer participation. It limits reimbursement for specific medical procedures like knee replacements and MRIs to the lowest available price, with exceptions for rural hospitals and emergency care. The bill also introduces a three-year commitment rule for private employers joining or leaving the state health plan and establishes a review process to assess savings from these changes.

Topics ✗ Budget & TaxesOpposes Budget & TaxesBill limits reimbursement for medical procedures to lowest prices, effectively capping state spending on health benefits.65% confidence ✗ HealthcareOpposes HealthcareBill limits reimbursement for specific medical procedures to the lowest available price, restricting patient access and reducing benefits.85% confidence

Sub-Topics Procurement Property Tax Insurance

Track

in committee · New Jersey · General Assembly May 14, 2026

A 5087: Establishes all-payer claims database.

This bill directs the New Jersey Department of Health to create an all-payer claims database that collects and stores health insurance data from various payers and providers. The database will include information on medical, prescription, dental, and vision claims, along with provider details and enrollment status, while excluding certain plans like Medicare supplements and workers' compensation. Covered entities such as insurance companies, hospitals, pharmacies, and third-party administrators must submit this data, except for self-insured plans governed by federal law. The Department is tasked with securely managing the data, auditing submissions for accuracy, and publishing reports on a public dashboard to improve transparency.

Topics ✓ HealthcareSupports HealthcareThe bill creates an all-payer claims database to improve healthcare data transparency and efficiency, supporting system-wide improvements.85% confidence

Sub-Topics Insurance Medicare

Track

in committee · New Jersey · Senate May 14, 2026

S 4233: Concerns health care services provided to incarcerated individuals.

This New Jersey bill ensures that incarcerated individuals do not have to pay for medical care, surgery, dental services, or prescription drugs provided while in state or county custody. It also requires courts to notify health insurance plans when sentencing someone to prison or detention if that person is covered by such a plan. Under the new rules, the state and counties can seek reimbursement from these insurance plans for the costs of medical treatment provided to inmates, rather than charging the inmates themselves. The legislation clarifies that these reimbursement efforts do not interfere with the existing responsibilities of correctional officials to provide care.

Topics ✓ Criminal JusticeSupports Criminal JusticeBill ensures incarcerated individuals receive necessary medical care without cost, protecting their civil rights and improving health outcomes, which supports criminal justice reform.90% confidence ✓ HealthcareSupports HealthcareBill ensures incarcerated individuals receive free medical care and establishes reimbursement mechanisms, expanding access and protecting patient rights.95% confidence

Sub-Topics Corrections Sentencing Insurance

Track

in committee · New Jersey · Senate May 11, 2026

S 4206: Requires pharmacy benefits managers to make certain disclosures to health benefits plan sponsors.

This New Jersey bill requires pharmacy benefits managers to provide health plan sponsors with detailed financial reports every six months. The legislation mandates that these reports include specific data on drug costs, rebates, and out-of-pocket spending for each prescription filled through different channels like retail or mail order. By demanding this information in plain language and machine-readable formats, the bill aims to increase transparency regarding how much money is exchanged between drug manufacturers, pharmacies, and insurance plans. Ultimately, the law seeks to help plan sponsors better understand the financial details of their pharmacy benefits contracts.

Topics ✓ HealthcareSupports HealthcareBill increases transparency in pharmacy benefits, helping plan sponsors and patients understand costs and rebates, thereby protecting patient financial interests.85% confidence

Sub-Topics Insurance Prescription Drugs

Track

in committee · New Jersey · General Assembly Jun 1, 2026

A 5181: Mandates insurance coverage for pain management services related to outpatient gynecological procedures.

This New Jersey bill requires all state-regulated health insurance plans to cover pain management services for patients undergoing outpatient gynecological procedures. It mandates that insurers treat these services the same as other medical conditions and prohibits them from labeling such pain management as elective or medically unnecessary. The law applies to a wide range of coverage types, including hospital, medical, and health service corporation contracts as well as individual and group health policies.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for pain management, expanding access and protecting patient rights.95% confidence

Sub-Topics Hospitals Insurance

Track

in committee · New Jersey · General Assembly May 7, 2026

A 4976: Mandates access to periodic cancer screening examinations for volunteer firefighters.

This bill requires New Jersey to reimburse volunteer firefighters for periodic cancer screenings that are not covered by their personal health insurance. Starting five years after beginning service, eligible firefighters can receive up to $1,250 every three years for exams covering various cancers, with the amount adjusted annually for inflation. The law ensures there are no out-of-pocket costs, such as deductibles or copayments, and treats volunteer firefighting as an occupational condition for reimbursement purposes. Funding for these payments will come from the state's general fund, and firefighters must provide appropriate records to claim the benefits.

Topics ✓ HealthcareSupports HealthcareBill mandates reimbursement for cancer screenings, expanding access and funding for healthcare services for volunteer firefighters.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill expands health benefits for volunteer firefighters by mandating reimbursement for cancer screenings, protecting worker welfare.90% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · Senate May 14, 2026

S 4243: Requires health insurance coverage for early-stage kidney disease screening without cost sharing.

This New Jersey bill mandates that health insurance plans cover early-stage kidney disease screening without requiring patients to pay deductibles, copayments, or coinsurance. It applies to individuals whose doctors determine the screening is medically necessary based on guidelines from the National Kidney Foundation. The law specifically requires coverage for two types of tests: a blood test to measure kidney function and a urine test to check for protein. Insurance companies must treat these screenings the same as other medical conditions, ensuring patients can access them without out-of-pocket costs.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for kidney disease screening without cost-sharing, expanding access and protecting patient rights.95% confidence

Sub-Topics Insurance

Track

in committee · New Jersey · Senate May 21, 2026

S 4329: Requires health insurance coverage for sepsis-related claims.

This New Jersey bill requires all health insurance plans, including hospital, medical, and individual policies, to cover sepsis-related treatments if a doctor deems them medically necessary. The law ensures that coverage for sepsis is provided with the same benefits as any other condition and applies to contracts and policies issued or renewed on or after the effective date. By mandating this coverage across various insurance types, the bill aims to guarantee financial support for individuals facing this serious medical condition without discrimination.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for sepsis treatments, expanding access and financial support for patients.95% confidence

Sub-Topics Hospitals Insurance

Track