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  • NJ A1807
  • Requires insurance coverage in the individual and small employer markets and SHBP and SEHBP for "off-label" uses of certain drugs.
Introduced
(1/27/2016)
In Committee
(9/8/2016)
Crossed OverPassedSignedDead/Failed/Vetoed
2016-2017 Regular Session
This bill requires those health benefits plans offered in the individual and small employer markets in New Jersey that provide benefits for drugs that are approved by the federal Food and Drug Administration (FDA), as well as the State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP), to provide coverage for certain "off-label" uses of those drugs for which they provide benefits. Off-label use of a drug, which is its use for a specific treatment for which the drug has not been approved by the FDA, is legal when prescribed in a medically appropriate way. The provisions of this bill apply to health insurers and programs including the health benefits plans issued pursuant to the Individual Health Coverage Program and the Small Employer Health Benefits Program; SHBP; SEHBP; hospital, medical, and health service corporations; commercial individual and group health insurers; and health maintenance organizations. The bill requires these insurers and programs to provide coverage for the off-label use of a drug, including medically necessary services associated with the drug, if the drug is: -- recognized as being medically appropriate for the specific treatment for which it has been prescribed in the American Hospital Formulary Service Drug Information or the United States Pharmacopeia Drug Information, which are the two established reference compendia; or -- recommended by a clinical study or review article in a major peer-reviewed professional journal. Coverage will not be required under the bill if the FDA has determined that the drug is contraindicated for the specific treatment for which it has been prescribed. The bill takes effect on the first day of the fourth month next following the date of enactment.
Health and Senior Services
Reported out of Asm. Comm. with Amendments, and Referred to Assembly Appropriations Committee  (on 9/8/2016)
 
 
Date Chamber Action Description
9/8/2016 A Reported out of Asm. Comm. with Amendments, and Referred to Assembly Appropriations Committee
9/8/2016 Assembly Health and Senior Services Hearing (10:00 9/8/2016 Committee Room 11, 4th Floor)
1/27/2016 A Introduced, Referred to Assembly Health and Senior Services Committee
Date Motion Yea Nay Other
Detail 9/8/2016 Assembly Health and Senior Services Committee: Reported with Amendments 12 0 1