This bill mandates that health insurance carriers and the State Medicaid and NJ FamilyCare programs provide coverage for prescription drugs prescribed for serious mental illnesses without requiring prior authorization or any form of utilization management, including step therapy protocols. The bill specifically defines "serious mental illness" to include various psychiatric conditions as outlined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders, such as bipolar disorders, major depressive disorders, obsessive-compulsive disorders, and schizophrenia.

Additionally, the bill amends existing law to ensure that carriers must comply with these coverage requirements, and it establishes that the Division of Medical Assistance and Health Services will enforce these provisions for Medicaid and NJ FamilyCare enrollees. The legislation aims to improve access to necessary medications for individuals suffering from serious mental illnesses, thereby enhancing their treatment options and overall mental health care. The bill is set to take effect 180 days after enactment and will apply to policies issued or renewed thereafter.

Statutes affected:
Introduced: 26:2S-10.8