Bill Text: NJ A5062 | 2026-2027 | Regular Session | Introduced

New Jersey Assembly Bill 5062

Introduced

Bill Title: Requires health insurance and Medicaid coverage for testing and treatments to slow progression of Alzheimer's disease and related disorders.

Sponsorship: Partisan Bill (Democrat 6)

Status: (Introduced) 2026-05-14 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A5062 Detail]

Download: New_Jersey-2026-A5062-Introduced.html

ASSEMBLY, No. 5062

STATE OF NEW JERSEY

222nd LEGISLATURE

INTRODUCED MAY 14, 2026

Sponsored by:

Assemblywoman CAROL A. MURPHY

District 7 (Burlington)

SYNOPSIS

Requires health insurance and Medicaid coverage for testing and treatments to slow progression of Alzheimer's disease and related disorders.

CURRENT VERSION OF TEXT

As introduced.

An Act concerning health insurance coverage for Alzheimer's disease and supplementing various parts of the statutory law.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. a. A hospital service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

b. The benefits shall be provided to the same extent as for any other condition under the contract, except that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related disorder pursuant to this section shall not be subject to any step therapy requirements.

c. This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.

2. a. A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

c. This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.

3. a. A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

c. This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.

4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for screening for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

b. The benefits shall be provided to the same extent as for any other condition under the policy, except that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related disorder pursuant to this section shall not be subject to any step therapy requirements.

c. This section shall apply to those individual health insurance policies in which the insurer has reserved the right to change the premium.

5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for screening for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

c. This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium.

6. a. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for screening for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

b. The benefits shall be provided to the same extent as for any other condition under the plan, except that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related disorder pursuant to this section shall not be subject to any step therapy requirements.

c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.

7. a. A small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.

8. a. A health maintenance organization contract for health care services that is delivered, issued, executed, or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

c. This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.

9. a. The State Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital and medical expense benefits shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

10. a. The School Employees' Health Benefits Commission shall ensure that every contract purchased by the commission on or after the effective date of this act that provides hospital and medical expense benefits shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

11. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall ensure that expenses incurred for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician, shall be provided to persons served under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).

b. The benefits shall be provided to the same extent as for any other condition under the program, except that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related disorder pursuant to this section shall not be subject to any step therapy requirements.

c. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.

12. This act shall take effect on the 180th day following the date of enactment, and shall apply to contracts delivered, issued, executed, or renewed on or after that date.

STATEMENT

This bill requires health insurance carriers (insurance companies, health, hospital, and medical service corporations, health maintenance organizations, and State and School Employees' Health Benefits Programs) and the State Medicaid Program to provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease and related disorders, in accordance with the U.S. Food and Drug Administration label, as determined by a physician.

The bill provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related disorder may not be subject to any step therapy requirements.