Bill
Bill > S796
NJ S796
Prohibits pre-approval or precertification of cancer treatments, tests, procedures and prescription drugs covered under health benefits or prescription drug benefits plans.
summary
Introduced
01/09/2024
01/09/2024
In Committee
01/09/2024
01/09/2024
Crossed Over
Passed
Dead
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill prohibits health insurers, third party administrators, pharmacy benefits managers, and the State Health Benefits Program and the School Employees' Health Benefits Program from requiring the pre-approval or precertification of treatments, tests, procedures, or prescription drugs covered under a health benefits or prescription drug benefits plan when prescribed for a covered individual who has been diagnosed with cancer. This bill will ensure that cancer patients are not burdened with technical requirements by health benefits providers which employ utilization management review systems that slow down medical care. The sponsor is concerned that complaints from people who need medical treatment are on the rise, and feels that it is time to end the nightmare of the insurance company bureaucracy that is frustrating patients who need care and medicine. The so-called "pre-approval" process, now required by insurance companies, is a nightmare for patients across New Jersey. Historically, doctors would order a treatment, test, or medicine and patients received it. Now, a myriad of bureaucratic obstacles makes patients and doctors pawns in a sad game of insurance-company chess. There are examples of cancer patients waiting for long periods of time to receive treatments or medicine because of a cumbersome and slow approval policy. The sponsor is convinced that it is time for the doctors to make decisions, not insurance companies; it is time for patients who have been diagnosed with cancer to not be burdened with technical requirements by insurance companies that employ systems that slow down medical care and are incredibly frustrating. It is the sponsor's goal that insurance companies pay for what the doctor orders.
AI Summary
This bill prohibits health insurers, third-party administrators, pharmacy benefits managers, and the State Health Benefits Program and the School Employees' Health Benefits Program from requiring pre-approval or precertification for treatments, tests, procedures, or prescription drugs covered under a health benefits or prescription drug benefits plan when prescribed for a covered individual who has been diagnosed with cancer. The bill aims to ensure that cancer patients are not burdened with technical requirements by health benefits providers that employ utilization management review systems, which can slow down medical care. The sponsor believes this will end the "nightmare" of insurance company bureaucracy that frustrates patients who need care and medicine.
Committee Categories
Business and Industry
Sponsors (2)
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee (on 01/09/2024)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
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State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/S796 |
BillText | https://pub.njleg.gov/Bills/2024/S1000/796_I1.HTM |
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