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  • NJ A1833
  • Mandates health benefits coverage for opioid analgesics with abuse-deterrent properties.
Introduced
(1/27/2016)
In Committee
(10/27/2016)
Crossed OverPassedSignedDead/Failed/Vetoed
2016-2017 Regular Session
This bill requires health insurers to provide health benefits coverage for prescribed abuse-deterrent opioid analgesic drugs. Opioid analgesic drugs are drugs prescribed to treat moderate to severe pain or other conditions. Abuse-deterrent opioid analgesic drugs are a brand or generic opioid analgesic drug approved by the United States Food and Drug Administration with abuse-deterrence labeling claims indicating its abuse-deterrent properties are expected to deter or reduce its abuse. The bill requires health insurers to provide coverage on the insurer's formulary, drug list, or other lists of similar construct, for at least one prescribed abuse-deterrent opioid analgesic drug product per opioid analgesic active ingredient, subject to the following: (1) Cost sharing for brand name abuse-deterrent opioid analgesic drug products shall not exceed the lowest cost sharing level applied to brand name non-abuse deterrent opioid drugs covered under the applicable contract; (2) Cost sharing for generic abuse deterrent opioid analgesic drug products shall not exceed the lowest cost sharing level applied to generic non-abuse deterrent opioid drugs covered under the applicable contract; (3) An increase in patient cost sharing or disincentives for a prescriber or dispenser shall not be allowed to achieve compliance with the bill's provisions; and (4) Any prior authorization requirements or other utilization review measures for opioid analgesic drugs, and any service denials made pursuant thereto, shall not require first use of non-abuse-deterrent opioid analgesic drugs in order to access opioid analgesic drugs with abuse-deterrent properties. The bill applies to health, hospital and medical service corporations; commercial individual and group health insurers; health maintenance organizations; health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs; the State Health Benefits Program; and the School Employees' Health Benefits Program.
2nd Reading in the Assembly, Financial Institutions and Insurance
Reported out of Assembly Committee, 2nd Reading  (on 10/27/2016)
 
 
Date Chamber Action Description
10/27/2016 A Reported out of Assembly Committee, 2nd Reading
10/27/2016 Assembly Appropriations Hearing (13:00 10/27/2016 Committee Room 11, 4th Floor)
6/2/2016 A Reported and Referred to Assembly Appropriations Committee
6/2/2016 A Transferred to Assembly Health and Senior Services Committee
6/2/2016 Assembly Health and Senior Services Hearing (10:00 6/2/2016 Committee Room 11, 4th Floor)
1/27/2016 A Introduced, Referred to Assembly Financial Institutions and Insurance Committee
Date Motion Yea Nay Other
Detail 10/27/2016 Assembly Appropriations Committee: Reported Favorably 9 2 0
Detail 6/2/2016 Assembly Health and Senior Services Committee: Reported Favorably 10 0 3