Bill
Bill > A1462
NJ A1462
NJ A1462"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 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 the State Health Benefits Program, must cover mammograms for any individual if their healthcare provider recommends the examination, regardless of age or specific risk factors. 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 "medically necessary" rather than simply "recommended" by a provider. The bill also ensures coverage for additional breast imaging tests, such as ultrasounds or MRIs, if a mammogram is abnormal or if the patient has risk factors, and these provisions apply to all relevant plans and policies issued or renewed after the bill's effective date.
Committee Categories
Business and Industry
Sponsors (6)
Brian Bergen (R)*,
Antwan McClellan (R)*,
Carol Murphy (D)*,
Vicky Flynn (R),
Gerry Scharfenberger (R),
Erik Simonsen (R),
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/13/2026)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2026/A1462 |
| BillText | https://pub.njleg.gov/Bills/2026/A1500/1462_I1.HTM |
Loading...