Bill > A5661

Introduced Session

This bill requires health insurance carriers and the State Medicaid and NJ FamilyCare programs to provide coverage for a prescription drug prescribed for serious mental illness to covered persons without the imposition of any prior authorization or other utilization management requirements, including, but not limited to, a step therapy protocol. Under the bill, "carrier" is defined to mean an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State or any entity contracted to administer health benefits in connection with the State Health Benefits Program or School Employees' Health Benefits Program. The bill defines "serious mental illness" to mean the following psychiatric illnesses, as defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders: (1) bipolar disorders including hypomanic, manic, depressive, and mixed; (2) depression in childhood and adolescence; (3) major depressive disorders, whether a single episode or recurrent; (4) obsessive compulsive disorders; (5) paranoid and other psychotic disorders; (6) schizo-affective disorders including bipolar and depressive; and (7) schizophrenia.

Committee Categories

Raj Mukherji (D)*,  Eliana Pintor Marin (D)*, 

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 06/26/2023)

Official Document