Bill Introduced to Remove Pre-Approval Obstacles

Bill Introduced to Remove Pre-Approval Obstacles - Healthcare Law Update - June 2025 - Brach Eichler
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6/1/2025

Assembly Bill 5571, introduced in the New Jersey Assembly on April 10, 2025, would prohibit insurance carriers from conditioning the payment of a medical test, procedure or prescription drug on pre-approval or precertification, as long as the medical test, procedure, or prescription drug is otherwise covered under a health benefit or prescription drug benefits plan. If enacted, the Bill would apply to health insurers, third party administrators, pharmacy benefits managers, the State Health Benefits Program and the School Employees’ Health Benefits Program to ensure that patients who are ill are not burdened with technical requirements and can receive treatment as ordered by providers.

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For more information, contact:
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Edward Hilzenrath | 973.403.3114 | ehilzenrath@bracheichler.com
Rebecca T. Falk | 973.364.8393 | rfalk@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare