Senate Commerce Committee Statement to Senate, No. 374 (May 18, 2026)

Summary

Statement to Senate, No. 374, with committee amendments, from the Senate Commerce Committee of the State of New Jersey, dated May 18, 2026, reporting Senate Bill No. 374 favorably. The statement says the amended bill requires health insurers to cover expenses for the treatment of lipedema, including compression garments, manual lymphatic drainage, medical nutrition therapy, mental health care and a lipectomy determined medically necessary by the covered person's surgeon. It says a carrier that denies coverage must give a detailed explanation, and cannot deny it solely based on photographs. The committee amendment aligns prior authorization requirements with the "Ensuring Transparency in Prior Authorization Act."

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     SENATE COMMERCE COMMITTEE

                     STATEMENT TO

                   SENATE, No. 374
                    with committee amendments



 STATE OF NEW JERSEY
                       DATED: MAY 18, 2026

    The Senate Commerce Committee reports favorably and with
committee amendments Senate Bill No. 374.
    As amended, this bill requires health insurers (health, hospital and
medical service corporations, commercial individual and group health
insurers; health maintenance organizations, health benefits plans
issued pursuant to the New Jersey Individual Health Coverage and
Small Employer Health Benefits Programs, the State Health Benefits
Program, and the School Employees’ Health Benefits Program) to
provide coverage for expenses incurred for the treatment of lipedema.
The expenses for which coverage is to be provided include
compression garments for all of the covered person’s affected
extremities, manual lymphatic drainage, medical nutrition therapy,
mental health care, lipectomy that is determined to be medically
necessary by the covered person’s surgeon, and pre-and post-
lipectomies appointments with the covered person’s physician and
surgeon.
     The bill requires a covered person to provide a carrier with
documentation from the covered person’s physician diagnosing the
covered person with lipedema and, if applicable, documentation from
the covered person’s surgeon that includes photographs of the covered
person that support the diagnosis and information on the number of
lipectomies the covered person’s surgeon deems medically necessary.
     Under the bill, a carrier is to provide coverage for the total number
of lipectomies deemed medically necessary by the covered person’s
surgeon and shall not require a covered person’s surgeon to remove
less fat than the surgeon deems medically necessary to be removed
from the covered person during lipectomy in order to receive
coverage. If a carrier denies coverage for expenses incurred for the
treatment of lipedema, the carrier is to provide the covered person with
a detailed explanation of the reason for the denial. A carrier cannot
deny coverage for expenses incurred for the treatment of lipedema
solely based on photographs of the covered person submitted pursuant
to the bill.
     Additionally, the bill provides that prior authorization granted by a
carrier for a lipectomy must be in accordance with prior authorization
requirements established pursuant to the “Ensuring Transparency in
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Prior Authorization Act.” Coverage is to be provided consistent with
the current standard of care for lipedema.
     Lipedema is a chronic, progressive condition characterized by
abnormal and often painful fat accumulation in specific areas of the
body. The condition does not have a cure, but lipectomy can help
remove fat and reduce the pain associated with the condition.
   This bill was prefiled for introduction in the 2026-2027 session
pending technical review. As amended and reported, the bill includes
the changes required by technical review, which has been performed.

COMMITTEE AMENDMENTS:
   The committee amended the bill to align prior authorization
requirements with the “Ensuring Transparency in Prior Authorization
Act.”


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