New Jersey A 5086: "Property Tax Relief Act"; makes various changes to SHBP and SEHBP administration and limits reimbursement for certain medical procedures.

Bill Text

A5086 

ASSEMBLY, No. 5086 

STATE OF NEW JERSEY

222nd LEGISLATURE

� 

INTRODUCED MAY 14, 2026

Sponsored by:

Assemblyman� ANDREW MACURDY

District 21 (Middlesex, Morris, Somerset and Union)

SYNOPSIS

���� �Property Tax Relief Act�; makes various changes to 
SHBP and SEHBP administration and limits reimbursement for certain medical 
procedures. 

CURRENT VERSION OF TEXT 

���� As introduced.

�� 

An Act concerning plan administration and reimbursement for 
certain procedures covered under the State Health Benefits Program and the 
School Employees� Health Benefits Program, amending and supplementing various 
parts of the statutory law, and repealing section 55 of P.L.2011, c.78.

���� Be It 
Enacted by the Senate and General Assembly of 
the State of New Jersey:

���� 1.� This act shall be known 
and may be cited as the �Property Tax Relief Act.�

���� 2.��� (New Section)� a.� 
Notwithstanding any law, rule, or regulation to the contrary, on or after the 
effective date of P.L.��� , c.���� (pending before the Legislature as this 
bill), any contract purchased or renewed by the State Health Benefits 
Commission, or its designee, pursuant to section 4 of P.L.1961, c.49 (C.52:14-17.28), 
shall limit reimbursement for knee replacements, hip replacements, magnetic 
resonance imaging (MRI) scans, computed tomography (CT) scans, colonoscopies, 
cataracts, arthroscopy, and diagnostic lab tests performed in an inpatient or 
outpatient hospital setting to the lesser of the contract price, the billed 
price, or the reference price as defined under subsection f. of this section.

���� b.� A carrier, hospital, or 
State-managed care plan shall not collect any money from a covered employee, 
retiree, dependent thereof, or the State Health Benefits Program in excess of 
the amount determined in accordance with subsection a. of this section for the 
listed procedures.

���� c.� (1) The provisions of this 
section shall not apply when a procedure listed under subsection a. of this 
section is performed in:

���� (a) a rural hospital that is 
certified by the U.S. Centers for Medicare and Medicaid Services as a sole 
community hospital, as defined in 42 U.S.C. s.1395ww(d)(5)(D)(iii); 

���� (b) a critical access hospital 
that is certified by the U.S. Centers for Medicare and Medicaid Services, as 
defined in 42 U.S.C. s.1395x(mm)(1); or

���� (c) a hospital with a monitor 
appointed by the New Jersey Department of Health pursuant to subsection c. of 
section 2 of P.L.2008, c.58 (C.26:2H-5.1a).

���� (2) The provisions of this 
section shall not apply when a procedure listed under subsection a. of this 
section is performed in an emergency. 

���� d. �The provisions of this 
section shall not be construed to require a health benefits plan offered by the 
State Health Benefits Program to provide reimbursement for claims using a 
fee-for-service payment method.

���� e.� Not later than two years 
after the effective date of P.L.��� , c.����� (pending before the Legislature 
as this bill), the Department of the Treasury shall evaluate the list of 
procedures specified in subsection a. of this section.� The evaluation shall 
assess the amount of money the program has saved on those procedures and 
recommend changes to the list of procedures for consideration by the 
Legislature.

���� f.� As used in this section, 
�reference price� means 165 percent of the amount paid by Medicare for the same 
or a similar procedure for in-network providers and 150 percent for 
out-of-network providers. 

���� 3.��� (New section) Notwithstanding 
the provisions of any other law, rule, or regulation to the contrary, within 
one year from the effective date of P.L.��� , c.����� (pending before the 
Legislature as this bill), any employer other than the State shall be required 
to make a determination as to whether to participate in the State Health 
Benefits Program.� Any employer other than the State which elects to 
participate in the State Health Benefits Program upon the conclusion of that 
year shall be required to remain enrolled in the program for a period of three 
consecutive plan years.� Any employer other than the State that elects to leave 
the program upon the conclusion of that year shall be prohibited from 
reenrolling in the program for three consecutive plan years.� Any employer 
other than the State that is not enrolled in the program and does not elect to 
participate within that year shall be permitted to join at any time, but shall 
be required to remain enrolled in the program for three consecutive plan years 
following new enrollment.

����� 4.� 
Section 3 of P.L.1961, c.49 (C.52:14-17.27) is amended to read as follows:

����� 3. a. There is hereby created 
a State Health Benefits Commission, consisting of five members: the State 
Treasurer; the Commissioner of Banking and Insurance; the Chairperson of the 
Civil Service Commission; a State employees' representative chosen by the 
Public Employee Committee of the AFL-CI