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NJ A434

NJ A434
Prohibits 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
01/13/2026
In Committee
02/12/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 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 ensures that individuals enrolled in the State Health Benefits Program (SHBP), School Employees' Health Benefits Program (SEHBP), and Medicaid will not have their coverage for essential maintenance medications for chronic conditions denied simply because their health benefits plan or pharmacy benefits manager (the company that manages prescription drug benefits) has changed. This protection applies only if the person was already taking the medication before the change and if the new plan or pharmacy benefits manager covers that particular class of drugs.

Committee Categories

Business and Industry, Health and Social Services

Sponsors (3)

Last Action

Reported and Referred to Assembly Health Committee (on 02/12/2026)

bill text


bill summary

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bill summary

Document Type Source Location
State Bill Page https://www.njleg.state.nj.us/bill-search/2026/A434
Analysis - Statement AFI 2/12/26 https://pub.njleg.gov/Bills/2026/A0500/434_S1.PDF
Analysis - Technical Review Of Prefiled Bill https://pub.njleg.gov/Bills/2026/A0500/434_T1.PDF
BillText https://pub.njleg.gov/Bills/2026/A0500/434_I1.HTM
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