Bill
Bill > S855
NJ S855
NJ S855"Michelle's Law"; requires health benefit plans to cover mammogram for an individual if recommended by health care provider.
summary
Introduced
01/13/2026
01/13/2026
In Committee
01/13/2026
01/13/2026
Crossed Over
Passed
Dead
Introduced Session
2026-2027 Regular Session
Bill Summary
This bill requires health benefit plans to cover the cost of a mammogram if a health care provider recommends the examination. Presently, health benefit plans are only required to cover mammograms for women who are 40 and over or women under the age of 40 if they have a family history of breast cancer or other breast cancer related risk factor. Health benefit plans must also cover additional testing of an entire breast or breasts after a baseline mammogram examination. Under this bill, health benefit plans will be required to cover the cost of a mammogram examination, and any additional testing after the examination, if the health care provider of the subscriber or other person covered under the plan recommends it. Mammograms for women 40 and over will still be covered under this bill. This bill, named "Michelle's Law," is in response to the tragic death of Michelle DeVita. Michelle was a 38-year-old woman who lost her battle to breast cancer. Under the requirements of the current law, insurance was not required to provide her coverage for a mammogram.
AI Summary
This bill, known as "Michelle's Law," mandates that all health benefit plans, including those from hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, health maintenance organizations (HMOs), and individual and small employer health benefits plans, must cover mammogram examinations and any subsequent recommended additional testing, such as ultrasounds or MRIs, if a covered person's healthcare provider recommends it, regardless of age or family history. Previously, coverage for women under 40 was limited to those with a family history of breast cancer or other risk factors, and the recommendation had to be deemed medically necessary by the woman's provider, whereas this bill broadens coverage by requiring it when a covered person's healthcare provider recommends it, aligning with the goal of ensuring earlier detection and treatment, inspired by the tragic death of Michelle DeVita, a 38-year-old who died from breast cancer when her insurance did not cover her mammogram.
Committee Categories
Health and Social Services
Sponsors (4)
Last Action
Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 01/13/2026)
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/2026/S855 |
| BillText | https://pub.njleg.gov/Bills/2026/S1000/855_I1.HTM |
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