Bill > A5393

This bill reduces the maximum copayment or coinsurance for prescription asthma inhalers from $50 to $35 for a 30-day supply across multiple types of health insurance plans in New Jersey, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, and health maintenance organizations. The bill applies to plans delivered, issued, executed, or renewed in the state, and covers inhalers prescribed by participating physicians or nurse practitioners. The copayment reduction applies to various types of health plans, including high-deductible and catastrophic plans, to the maximum extent permitted by federal law. Each type of health plan is prohibited from charging a deductible for the asthma inhaler, and insurers retain the flexibility to reduce cost-sharing requirements beyond the $35 limit. The bill also requires the State Health Benefits Commission and the School Employees' Health Benefits Commission to ensure their contracts comply with this new coverage standard. The bill will take effect on the first day of the seventh month after enactment and will apply to plans issued or renewed on or after January 1 of the next calendar year.

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https://www.njleg.state.nj.us/bill-search/2024/A5393