Bill > A5719

Introduced Session

This bill requires health insurers (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) to provide health benefits coverage for any expenses incurred by a covered person for the prescription and purchase of buprenorphine or buprenorphine/naloxone for the treatment of pain. The bill provides that coverage is not subject to step therapy or fail-first protocols. Buprenorphine and buprenorphine/naloxone, are medications that are used to treat chronic pain. This bill seeks to make these medications more readily available for people with chronic pain by prohibiting health insurers from applying step therapy or fail-first protocols as a condition for coverage. These protocols are a type of prior authorization which currently may be used by health insurers to require patients to use riskier, more addictive drugs for the treatment of pain, before using buprenorphine and buprenorphine/naloxone, which are less addictive and less likely to be abused by patients.

AI Summary

Committee Categories

Carol Murphy (D)*, 

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 08/23/2019)

Official Document