Bill
Bill > S3712
NJ S3712
NJ S3712Prohibits 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
03/02/2026
03/02/2026
In Committee
03/02/2026
03/02/2026
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 continue to have coverage for maintenance medications for chronic conditions even if their health benefits plan or pharmacy benefits manager (PBM) changes. A PBM is a company that manages prescription drug benefits on behalf of health insurers. The bill prohibits these programs from denying coverage for a medication if the person was already taking it before the change and if the new plan or PBM covers that category of drugs. This aims to prevent disruptions in care for individuals managing long-term health issues when their insurance or drug benefit administrator is updated.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 03/02/2026)
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/S3712 |
| BillText | https://pub.njleg.gov/Bills/2026/S4000/3712_I1.HTM |
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