Bill > S2918

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) schizophrenia, schizo-affective disorders including bipolar and depressive, and bipolar disorders including hypomanic, manic, depressive, and mixed; (2) major depressive disorders, whether a single episode or recurrent, including, but not limited to, any major depressive disorder with peripartum onset; and (3) post-traumatic stress disorder. This bill provides that coverage for drugs prescribed for serious mental illness to covered persons without prior authorization or utilization management is only required if the drug is prescribed by a psychiatrist or an obstetrician/gynecologist, during the postpartum period. This bill also provides that if a person has been stable and appropriately treated for a serious mental illness using a drug prescribed by a psychiatrist or an obstetrician/gynecologist for a period of six months, another prescriber may continue prescribing that drug without prior authorization or utilization management requirements. This bill also provides that the requirement for coverage for drugs for serious mental illness without prior authorization or utilization management only applies to persons who are 18 years of age or older.

AI Summary

Committee Categories

Vin Gopal (D)*,  Raj Mukherji (D)*,  Jon Bramnick (R),  Tony Bucco (R),  Renee Burgess (D),  Gordon Johnson (D),  Angela Mcknight (D),  Teresa Ruiz (D),  Douglas Steinhardt (R),  Benjie Wimberly (D), 

Introduced in the Senate, Referred to Senate Commerce Committee (on 01/13/2026)

Official Document