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 oversee the implementation of these provisions within the Medicaid and NJ FamilyCare programs. The legislation aims to enhance access to necessary medications for individuals suffering from serious mental illnesses, thereby promoting better mental health outcomes without the barriers typically associated with prior authorization processes. The act will take effect 180 days after enactment and will apply to policies issued or renewed thereafter.

Statutes affected:
Introduced: 26:2S-10.8