ASSEMBLY APPROPRIATIONS COMMITTEE

STATEMENT TO

[First Reprint]

ASSEMBLY, No. 5785

STATE OF NEW JERSEY

DATED:  DECEMBER 18, 2025

      The Assembly Appropriations Committee reports favorably Assembly Bill No. 5785 (1R).

      As reported, 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 preventive services that are recommended on an annual basis at least once per calendar year, without requiring any waiting period.  Nothing within the bill requires coverage of duplicative services unless a provider determines those services are clinically indicated.  An insurer under the bill may also require a waiting period if it is medically necessary to ensure the safety of the services.

      This bill is intended to prevent insurers from requiring covered persons to wait a full 12 months between visits to health care providers, which can result in persons not being able to properly schedule visits to receive preventive services.

FISCAL IMPACT:

      The Office of Legislative Services (OLS) determines that requiring every contract purchased by the State Health Benefits Commission and the School Employees’ Health Benefits Commission to provide coverage for preventive services recommended on an annual basis at least once per calendar year without requiring any waiting period, except as necessary to ensure the safety of those services, may result in annual indeterminate expenditure increases to the State and participating local government employers if such requirements increase the frequency or utilization of such services beyond current levels.