New Jersey S 2918: Allows corporation business tax and gross income tax credits to businesses employing released nonviolent offenders.

Bill Text

S2918 

SENATE, No. 2918 

STATE OF NEW JERSEY

222nd LEGISLATURE

� 

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Senator RAJ MUKHERJI

District 32 (Hudson)

Senator VIN GOPAL

District 11 (Monmouth)

Co-Sponsored by:

Senators Johnson, Bramnick, Ruiz, Burgess, Steinhardt, 
Wimberly, A.M.Bucco and McKnight

SYNOPSIS

���� Requires prescription drug coverage for serious 
mental illness without prior authorization or utilization management, including 
step therapy.

CURRENT VERSION OF TEXT 

���� Introduced Pending Technical Review by Legislative 
Counsel.

��

An Act concerning utilization management, amending P.L.2019, 
c.58, and supplementing P.L.1968, c.413 (30:4D-1 et seq.).

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

����� 1.�� Section 
11 of P.L.2019, c.58 (C.26:2S-10.8) is amended to read as follows:

����� 11.� 
a.� For the purposes of this section:

����� "Benefit 
limits" includes both quantitative treatment limitations and 
non-quantitative treatment limitations. 

����� "Carrier" 
means an insurance company, health service corporation, hospital service 
corporation, medical service corporation, or health maintenance organization 
authorized to issue health benefits plans in this State or any entity 
contracted to administer health benefits in connection with the State Health 
Benefits Program or School Employees' Health Benefits Program.

����� "Classification 
of benefits" means the classifications of benefits found at 45 C.F.R. 
146.136(c)(2)(ii)(A) and 45 C.F.R. s.146.136(c)(3)(iii).

����� "Department" 
means the Department of Banking and Insurance.

"Mental 
health condition" means a condition defined to be consistent with 
generally recognized independent standards of current medical practice 
referenced in the current version of the Diagnostic and Statistical Manual of 
Mental Disorders.

����� "Non-quantitative 
treatment limitations" or "NQTL" means processes, strategies, or 
evidentiary standards, or other factors that are not expressed numerically, but 
otherwise limit the scope or duration of benefits for treatment. NQTLs shall 
include, but shall not be limited to:

����� (1)� Medical 
management standards limiting or excluding benefits based on medical necessity 
or medical appropriateness, or based on whether the treatment is experimental 
or investigative;

����� (2)� Formulary 
design for prescription drugs;

����� (3)� For 
plans with multiple network tiers, such as preferred providers and 
participating providers, network tier design;

����� (4)� Standards 
for provider admission to participate in a network, including reimbursement 
rates;

����� (5)� Plan 
methods for determining usual, customary, and reasonable charges;

����� (6)� Refusal 
to pay for higher-cost therapies until it can be shown that a lower-cost 
therapy is not effective, also known as fail-first policies or step therapy 
protocols;

����� (7)� Exclusions 
based on failure to complete a course of treatment;

����� (8)� Restrictions 
based on geographic location, facility type, provider specialty, and other 
criteria that limit the scope or duration of benefits for services provided 
under the plan or coverage;

����� (9)� In 
and out-of-network geographic limitations;

����� (10)� 
Limitations on inpatient services for situations where the participant is a 
threat to self or others;

����� (11)� 
Exclusions for court-ordered and involuntary holds;

����� (12)� 
Experimental treatment limitations;

����� (13)� 
Service coding;

����� (14)� 
Exclusions for services provided by a licensed professional who provides mental 
health condition or substance use disorder services;

����� (15)� 
Network adequacy; and

����� (16)� 
Provider reimbursement rates.

����� �Serious 
mental illness� means the following psychiatric illnesses as defined in the 
most current version of the Diagnostic and Statistical Manual of Mental 
Disorders:

����� (1)� schizophrenia, 
schizo-affective disorders including bipolar and depressive, and bipolar 
disorders including hypomanic, manic, depressive, and mixed;

����� (2) 
major depressive disorders, whether a single episode or recurrent, including, 
but not limited to, any major depressive disorder with peripartum onset; and

����� (3) 
post-traumatic stress disorder.

����� "Substance 
use disorder" means a disorder defined to be consistent with generally 
recognized independent standards of current medical practice referenced in the 
most current version of the Diagnostic and Statistical Manual of Mental 
Disorders.

����� b.�� A 
carrier shall approve a request for an in-plan exception if the carrier's 
network does not have any providers who are qualified, accessible and available 
to perform the specific medically necessary service. A carrier shall 
communicate the availability of in-plan exceptions: 

����� (1)� on 
its website where lists of network providers are displayed; and

����� (2)� to 
beneficiaries when they