Healthcare (Insurance) in New Jersey

in committee · New Jersey · Senate Mar 19, 2026

S 4036: Requires Medicaid and health insurance network contracts to provide participating health care providers with certain notifications.

This bill requires insurance companies and Medicaid programs in New Jersey to give health care providers at least six months' notice before making policy changes that could lead to coverage denials. It directly affects doctors, hospitals, and other providers who have contracts with managed care plans, ensuring they have advance warning of potential restrictions on the services they can offer. The law applies to all insurance carriers and state health programs authorized to issue health benefits in the state, including the State Health Benefits Program and School Employees' Health Benefits Program. This change takes effect 120 days after enactment and applies to any new or renewed contracts signed after that date.

Topics ✓ Healthcare

Sub-Topics Insurance Medicaid

in committee · New Jersey · Senate Mar 19, 2026

S 4003: Requires Medicaid coverage for continuous glucose monitors and related supplies for individuals diagnosed with diabetes who meet certain coverage eligibility criteria.

This bill requires New Jersey Medicaid to cover continuous glucose monitors and related supplies for individuals diagnosed with diabetes who meet specific eligibility criteria. The legislation amends existing Medicaid statutes to include these medical devices and necessary supplies as authorized services under the program. Directly affected individuals are Medicaid recipients with diabetes who would gain access to these monitoring tools through their state health insurance coverage. The bill operates within federal Medicaid guidelines and does not alter eligibility requirements for the program itself.

Topics ✓ Healthcare

Sub-Topics Insurance Medicaid

signed · New Jersey · Senate Jun 30, 2026

S 3947: Extends certain pay parity regarding telemedicine and telehealth.*

This bill permanently extends pay parity for telemedicine and telehealth services in New Jersey, requiring health insurance carriers to reimburse providers at the same rates as in-person care. It directly affects insurance companies, healthcare providers, and patients by mandating that out-of-pocket costs like deductibles and copayments for virtual visits cannot exceed those for in-person appointments. The legislation also prohibits insurers from restricting telehealth platforms, limiting service locations, or denying coverage for routine remote monitoring if the same care would be covered in person. Additionally, carriers must continue to allow patients to choose between in-person and virtual care rather than forcing telehealth as a substitute.

Topics ✓ Healthcare ✓ Technology

Sub-Topics Insurance Telehealth

in committee · New Jersey · Senate Mar 10, 2026

S 3866: Mandates access to periodic cancer screening examinations for volunteer firefighters; increases tax on fire insurance premiums.

This bill requires volunteer firefighters in New Jersey to receive state-funded cancer screenings at least once every three years, covering specific types of cancer including colon, lung, and prostate. The program reimburses up to $1,250 per three-year period for exams not covered by personal health insurance, with no co-pays or deductibles required. Funding comes from a dedicated state revolving fund that also receives additional revenue from a 0.1% tax on fire insurance premiums paid by out-of-state insurers. The tax revenue is split between the New Jersey Firemen's Home and the new firefighter screening fund, with the remainder returned to the State Firemen's Association.

Topics ✓ Budget & Taxes ✓ Healthcare

Sub-Topics Revenue Insurance

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

A 3122: Requires health benefits coverage for family planning and reproductive health care services, including early infancy care, without cost sharing.

This New Jersey bill requires health insurance plans sold in the state and the Medicaid program to cover specific family planning and reproductive health services without any out-of-pocket costs for enrollees. It mandates no deductibles, copayments, or coinsurance for services including abortion (both aspiration and medication types), emergency care for mothers/newborns, contraception counseling, genetic testing, inpatient care for mothers and infants, well-baby visits, and ultrasounds. The coverage applies to all in-network providers under insurance contracts and Medicaid, but excludes childbirth services. Religious employers may still qualify for exemptions under existing law.

Topics ✓ Healthcare ✓ Labor & Employment

Sub-Topics Hospitals Insurance Women's Health

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

A 1893: Modifies laws regarding compensation and leaves of absence for certain public employees who served in the military; requires public employers follow certain policies and procedures for leaves of absence.

This bill modifies New Jersey law to improve leave and compensation for public employees who serve in military reserves or the National Guard. It guarantees up to 30 work days of paid leave per year (90 days for National Guard members) for military duty, including travel days and pre-deployment rest periods (5-10 days based on service length). Public employers must continue covering retirement and health insurance contributions during leave, and employees cannot be forced to use vacation time during military leave. The law directly affects state, county, and municipal employees who are active military reservists or National Guard members.

Topics ✓ Healthcare ✓ Labor & Employment

Sub-Topics Insurance Paid Leave Public Employees

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

A 1941: Requires health insurers to provide coverage for hearing aids.

This New Jersey bill (A 1941) requires most health insurance plans sold in the state to cover hearing aids. It directly affects health insurers and policyholders by mandating coverage for one hearing aid per ear every 48 months (4 years) when prescribed by a licensed audiologist or hearing aid dispenser. The policy limits out-of-pocket costs to no more than 15% of the hearing aid's price, including copays or deductibles. This applies to hospital service corporations, medical service corporations, health service corporations, group and individual health insurance policies, HMOs, and health benefits plans. The bill does not cover hearing aids for cosmetic purposes, only medically necessary ones.

Topics ✓ Healthcare

Sub-Topics Hospitals Insurance

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

A 1966: Increases accidental death benefit for certain members of PERS.

This bill increases accidental death benefits for firefighters, emergency medical technicians, paramedics, hazardous materials responders, and fire instructors in New Jersey's Public Employees' Retirement System (PERS). It raises the surviving spouse's pension from 50% to 70% of the member's final salary-based compensation (or $50,000, whichever is greater), and expands child benefits to 70% if no spouse survives. The bill also adds retroactive health insurance coverage for surviving spouses and children through employer-sponsored plans, and requires lump-sum payments for the difference between old and new benefits dating back to January 1, 2021. These changes align PERS accidental death benefits with those provided under the Police and Firemen’s Retirement System.

Topics ✓ Healthcare ✓ Labor & Employment

Sub-Topics Insurance

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

A 4251: Establishes "Automobile Accident Injury Fund."

This bill establishes a permanent "Automobile Accident Injury Fund" within New Jersey's Department of Banking and Insurance. It provides coverage for medical costs incurred by individuals injured in accidents involving a stolen vehicle, specifically when the injured person has no health insurance or automobile insurance that covers the medical expenses. The fund covers these costs regardless of whether the stolen vehicle was properly insured under state law. The Department of Banking and Insurance will manage the fund, create application procedures, and determine payment amounts for eligible applicants. This directly affects uninsured residents injured by stolen vehicles, addressing gaps when personal insurance fails to cover treatment.

Topics ✓ Healthcare

Sub-Topics Insurance

in committee · New Jersey · Senate Feb 19, 2026

S 3570: Requires availability of electronic fund transfers by health insurance carriers to reimburse covered persons.

This bill requires New Jersey health insurance companies to offer electronic fund transfers (EFT) as a standard option for reimbursing covered persons (policyholders) for medical expenses. It mandates that insurers must notify policyholders about any fees for using EFT and provide clear instructions on their website for selecting this payment method. Insurers who fail to comply may face fines from the Department of Banking and Insurance and must reimburse policyholders for any fees they incurred due to non-compliance. The law applies to all standard health insurance plans (excluding Medicare, Medicaid, workers' compensation, and similar coverage) for claims submitted after the effective date.

Topics ✓ Healthcare

Sub-Topics Insurance Medicaid Medicare

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