Bill
Bill > A434
NJ A434
NJ A434Prohibits 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
01/13/2026
In Committee
02/12/2026
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)
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/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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