Bill
Bill > A4275
NJ A4275
NJ A4275Prohibits 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
05/02/2024
05/02/2024
In Committee
10/24/2024
10/24/2024
Crossed Over
Passed
Dead
01/12/2026
01/12/2026
Introduced Session
2024-2025 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 for chronic conditions for covered persons solely because of a change in their health benefits plan or pharmacy benefits manager. The prohibition applies if the covered person was already taking the medication prior to the change and the new plan or pharmacy benefits manager provides coverage for that class of drugs.
Committee Categories
Budget and Finance, Business and Industry
Sponsors (2)
Last Action
Reported and Referred to Assembly Appropriations Committee (on 10/24/2024)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/A4275 |
| Fiscal Note - Fiscal Estimate 2/14/25; as introduced | https://pub.njleg.gov/Bills/2024/A4500/4275_E1.PDF |
| Analysis - Statement AFI 10/24/24 | https://pub.njleg.gov/Bills/2024/A4500/4275_S1.PDF |
| BillText | https://pub.njleg.gov/Bills/2024/A4500/4275_I1.HTM |
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