Senate Commerce Committee Statement to Senate, No. 1192 — State of New Jersey (May 13, 2024)

Summary

A Senate Commerce Committee statement to the Senate on Senate Bill No. 1192 with committee amendments, State of New Jersey, dated May 13, 2024, reporting the bill favorably. As amended, the bill requires health insurance carriers and the State Medicaid and NJ FamilyCare programs to cover a prescription drug prescribed for serious mental illness without prior authorization or other utilization management requirements, including a step therapy protocol. It defines "serious mental illness" by listed psychiatric illnesses in the Diagnostic and Statistical Manual of Mental Disorders, among them bipolar disorders, schizophrenia and obsessive compulsive disorders. The committee amendments add major depressive disorders with peripartum onset and post-traumatic stress disorder to that definition.

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SENATE COMMERCE COMMITTEE

STATEMENT TO

SENATE, No.
1192

with
committee amendments

STATE
OF NEW JERSEY

DATED: MAY 13,
2024

The Senate Commerce Committee reports favorably and
with committee amendments Senate Bill No. 1192.

As
amended, this bill requires health insurance carriers and the State Medicaid
and NJ FamilyCare programs to provide coverage for a prescription drug
prescribed for serious mental illness to covered persons without the imposition
of any prior authorization or other utilization management requirements,
including, but not limited to, a step therapy protocol.

Under
the bill, “carrier" is defined to mean an insurance company, health
service corporation, hospital service corporation, medical service corporation,
or health maintenance organization authorized to issue health benefits plans in
this State or any entity contracted to administer health benefits in connection
with the State Health Benefits Program or School Employees' Health Benefits
Program.

The
bill defines “serious mental illness” to mean the following psychiatric
illnesses, as defined in the most current version of the Diagnostic and
Statistical Manual of Mental Disorders:

(1) bipolar
disorders including hypomanic, manic, depressive, and mixed;

(2) depression
in childhood and adolescence;

(3) major
depressive disorders, whether a single episode or recurrent, i ncluding,
but not limited to, any major depressive disorder with peripartum onset ;

(4) obsessive
compulsive disorders;

(5) paranoid
and other psychotic disorders;

(6) schizo-affective
disorders including bipolar and depressive;

(7) schizophrenia;
and

(8) post-traumatic
stress disorder.

This bill was pre-filed for introduction in the
2024-2025 session pending technical review. As reported, the bill includes the
changes required by technical review, which has been performed.

COMMITTEE AMENDMENTS :

The committee amended the bill to stipulate that the
definition of “serious mental illness” includes major depressive disorders with
peripartum onset and post-traumatic stress disorder.

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