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Bill > S1650


NJ S1650

NJ S1650
Requires health benefits coverage for buprenorphine and buprenorphine/naloxone for pain treatment without step therapy or fail-first protocols.


summary

Introduced
02/13/2020
In Committee
02/13/2020
Crossed Over
Passed
Dead
01/11/2022

Introduced Session

2020-2021 Regular Session

Bill Summary

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

This bill requires health insurers in New Jersey to provide coverage for the prescription and purchase of buprenorphine or buprenorphine/naloxone for the treatment of pain, without subjecting such coverage to step therapy or fail-first protocols. Buprenorphine and buprenorphine/naloxone are medications used to treat chronic pain that are less addictive and less likely to be abused compared to other pain medications. The bill applies to various types of health insurance plans, including hospital service corporation contracts, medical service corporation contracts, health service corporation contracts, individual and group health insurance policies, individual and small employer health benefits plans, and health maintenance organization contracts. The bill also requires the State Health Benefits Commission and the School Employees' Health Benefits Commission to ensure that their respective health insurance contracts provide this coverage.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Introduced in the Senate, Referred to Senate Commerce Committee (on 02/13/2020)

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