ASSEMBLY APPROPRIATIONS COMMITTEE
STATEMENT TO
[First Reprint]
ASSEMBLY, No. 4838
with committee amendments
STATE OF NEW JERSEY
DATED: DECEMBER 18, 2025
The Assembly Appropriations Committee reports favorably and with committee amendments Assembly Bill No. 4838 (1R).
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, if the prescriber is a psychiatrist or an obstetrician/gynecologist, during the postpartum period.
The bill provides that if a person has been stable and appropriately treated for a serious mental illness using a drug prescribed by a psychiatrist or an obstetrician/gynecologist for a period of six months, another prescriber may continue prescribing that drug without prior authorization or utilization management requirements. The bill also provides that the requirement for coverage of drugs for serious mental illness without prior authorization or utilization management only applies to persons who are 18 years of age or older.
The bill defines “carrier" 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. As used in the bill, “carrier” does not include any entity contracted to administer health benefits in connection with the State Health Benefits Program or School Employees' Health Benefits Program.
COMMITTEE AMENDMENTS:
The committee amended the bill to provide that the requirements of the bill do not apply to any entity contracted to administer health benefits in connection with the State Health Benefits Program or School Employees' Health Benefits Program.
FISCAL IMPACT:
Fiscal information for this bill is currently unavailable.