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Bill > A692


NJ A692

NJ A692
Limits upfront costs for oral anticancer medications for persons covered under certain health benefits plans.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

This bill limits the amount that a covered person is required to pay upfront in order to obtain oral anticancer medications by amending P.L.2011, c. 188, which requires health insurers, the State Health Benefits Program, and the School Employees' Health Benefits Program to cover oral anticancer medications on a basis no less favorable than intravenous anticancer medications. Specifically, the bill provides that, except for any copayment, deductible or coinsurance required to be paid by the covered person pursuant to the contract or policy, a contract or policy shall not require a covered person to pay any additional upfront cost or out of pocket expense for orally administered anticancer medications, even if reimbursement for that cost or expense is to be provided to the covered person at a later date. Due to the extremely high cost of many oral anticancer medications, many patients cannot afford to pay for these medications upfront and wait for reimbursement from their insurer or health benefits plan at a later date. This bill attempts to remedy these situations by limiting upfront costs to the patient's copayment, deductible or coinsurance.

AI Summary

This bill amends existing law to limit the upfront costs individuals must pay for oral anticancer medications under certain health benefit plans, including those offered by hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, individual and small employer health benefit plans, health maintenance organizations, the State Health Benefits Program, and the School Employees' Health Benefits Program. The key provision is that, except for the patient's standard copayment, deductible, or coinsurance, these plans cannot require individuals to pay any additional upfront costs or out-of-pocket expenses for orally administered anticancer medications, even if reimbursement is promised later. This change is intended to address the financial burden of high-cost oral cancer drugs, as many patients cannot afford to pay the full price upfront while waiting for their insurance to reimburse them.

Committee Categories

Education

Sponsors (2)

Last Action

Introduced, Referred to Assembly Education Committee (on 01/13/2026)

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