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Bill > S1876


NJ S1876

NJ S1876
Prohibits SHBP, SEHBP, and Medicaid from denying coverage for maintenance medications for chronic conditions for covered persons solely because of change in health benefits plan or pharmacy benefits manager.


summary

Introduced
02/24/2020
In Committee
02/24/2020
Crossed Over
Passed
Dead
01/11/2022

Introduced Session

2020-2021 Regular Session

Bill Summary

This bill would prohibit contracts which are issued or purchased pursuant to the State Health Benefits Program, School Employees' Health Benefits Program, and Medicaid Program from denying coverage for a maintenance medication prescribed by a covered person's physician for the covered person's chronic condition because of a change in the covered person's pharmaceutical benefits that results solely from a change in the health benefits plan or the pharmacy benefits manager for that plan. The prohibition applies only if the covered person was taking the medication prior to the date of the change in the covered person's health benefits plan or the pharmacy benefits manager for that plan, and if the covered person's new health benefits plan, or health benefits plan under the new pharmacy benefits manager, as applicable, provides coverage for that class of drugs.

AI Summary

This bill prohibits the State Health Benefits Program (SHBP), the School Employees' Health Benefits Program (SEHBP), and Medicaid from denying coverage for maintenance medications prescribed for a covered person's chronic condition solely because of a change in the person's health benefits plan or pharmacy benefits manager. The prohibition applies if the person was taking the medication prior to the change and the new plan or manager provides coverage for that class of drugs.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 02/24/2020)

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