ASSEMBLY APPROPRIATIONS COMMITTEE

STATEMENT TO

ASSEMBLY, No. 1821

STATE OF NEW JERSEY

DATED:  JUNE 23, 2026

      The Assembly Appropriations Committee reports favorably Assembly Bill No. 1821.

      As reported, this bill makes it unlawful when a licensed health care provider prescribes a nonopioid medication to a person covered by a health insurance carrier for the treatment of acute pain and the carrier denies coverage of a nonopioid prescription drug:  (1) in favor of an opioid prescription drug; or (2) to require a covered person to try an opioid prescription drug prior to approving the use of a nonopioid prescription drug.

      Under the bill, a carrier that establishes and maintains a drug formulary is to ensure that a nonopioid drug approved by the United States Food and Drug Administration for the treatment or management of pain will not be disadvantaged or discouraged, with respect to coverage or cost-sharing, relative to any opioid or narcotic drug for the treatment or management of pain on the formulary of the carrier under various circumstances.  It is not prohibited in the bill for an opioid drug to be preferred over another opioid drug or for a nonopioid drug to be preferred over another nonopioid drug.

      The provisions of the bill prohibiting denial of a nonopioid prescription drug are also incorporated into the laws governing the required coverage for contracts negotiated by the State Health Benefits Commission and the School Employees’ Health Benefits Commission, and in the law overseeing Medicaid.

FISCAL IMPACT:

      The Office of Legislative Services (OLS) finds that prohibiting health insurance carriers from denying coverage of nonopioid prescription drugs in favor of opioid prescription drugs may result in potential indeterminate annual cost increases to the State and participating local governments and school districts in relation to the State Health Benefits Program and the School Employees’ Health Benefits Program, to the extent that the programs currently implement utilization control policies that favor less-expensive opioid drugs over more-expensive nonopioid drug equivalents.

      This prohibition may also result in indeterminate annual cost increases to the State Medicaid Program to the extent that the program currently implements utilization control policies that favor less-expensive opioid drugs over more-expensive nonopioid drug equivalents.

      Any increase in State expenditures under NJ FamilyCare would concomitantly grow annual State revenues by an indeterminate amount in the form of federal Medicaid cost reimbursements.