Bill Text: NJ A4449 | 2026-2027 | Regular Session | Introduced
Bill Title: Requires DOBI to review hormone replacement therapy coverage.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced) 2026-02-24 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A4449 Detail]
Download: New_Jersey-2026-A4449-Introduced.html
Sponsored by:
Assemblywoman HEATHER SIMMONS
District 3 (Cumberland, Gloucester and Salem)
SYNOPSIS
Requires DOBI to review hormone replacement therapy coverage.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the Department of Banking and Insurance and hormone replacement therapy and supplementing P.L.2025, c.200 (C.17:48-6bbb et al.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Department of Banking and Insurance shall conduct a confidential review of:
(1) the administration of hormone replacement therapy coverage by health insurance carriers pursuant to the "New Jersey Menopause Coverage Act," P.L.2025, c.200 (C.17:48-6bbb et al.); and
(2) pursuant to paragraph (1) of this subsection, whether there is an aggregate increase in hormone replacement therapy coverage by health insurance carriers after the effective date of P.L.2025, c.200 (C.17:48-6bbb et al.).
b. For the purposes of subsection a. of this act, the department shall review:
(1) data on prior authorization and step therapy exception approvals and denials for hormone replacement therapy coverage, as provided pursuant to section 17 of the "Ensuring Transparency in Prior Authorization Act," P.L.2023, c.296 (C.17B:30-55.16) and section 5 of P.L.2025, c.50 (C.30:4D-7yy); and
(2) other information, as determined by the Commissioner of Banking and Insurance, from a health insurance carrier that is gathered in the carrier's ordinary course of business.
c. Conclusions of the review conducted by the department pursuant to this section shall be transmitted to the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), six months after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill).
2. This act shall take effect immediately and shall expire upon the submission of the department's conclusions of the review to the Legislature.
STATEMENT
This bill requires DOBI to review hormone replacement therapy coverage provided by carriers pursuant to the "New Jersey Menopause Coverage Act."
Under the bill, DOBI will be required to conduct a one-time confidential review to examine:
(1) the administration of hormone replacement therapy coverage by health insurance carriers pursuant to the "New Jersey Menopause Coverage Act;" and
(2) whether there is an aggregate increase in hormone replacement therapy coverage by health insurance carriers after enactment of that act.
The bill provides that the department will review data on prior authorization and step therapy exception approvals and denials that are available, as well as other information, as determined by the department, from health insurance carriers as collected in the carrier's ordinary course of business. The conclusions of the review conducted by DOBI will be required to be transmitted to the Legislature six months after this bill's effective date.
