This bill amends existing New Jersey legislation to lower the copayment for prescription asthma inhalers from $50 to $35 for a 30-day supply, thereby reducing out-of-pocket costs for patients. The new copayment standard applies to a variety of health insurance plans, including individual and group hospital service corporations, medical service corporations, health service corporations, and health maintenance organizations. Additionally, the bill ensures that coverage for asthma inhalers is not subject to any deductible, enhancing access to necessary medications for individuals with asthma.

The legislation also clarifies that these provisions will apply to high-deductible health plans as permitted by federal law, while allowing exceptions for medical savings accounts and health savings accounts. It permits health insurers and service corporations to further reduce cost-sharing requirements beyond the specified amounts. The bill mandates compliance with the new coverage standard by the State Health Benefits Commission and the School Employees Health Benefits Commission, while also allowing these commissions to implement strategies to encourage the use of lower-cost generic alternatives. The act is set to take effect on the first day of the seventh month following its enactment and will apply to plans issued or renewed on or after January 1 of the next calendar year.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.49, 17B:26-2.1, 17B:27-46.1, 26:2J-4.50, 17B:27A-7.33, 17B:27A-19.37, 52:14-17.29, 52:14-17.46.6