New Jersey Assembly Bill A504

New Jersey 2022-2023 Regular Session

• Introduced: 1/11/22
• Refer: 1/11/22

Caption

Requires health insurers to provide coverage for epinephrine for persons aged 18 or younger.

Impact

A504 is expected to significantly impact state health insurance regulations by ensuring that all insurers, including health service and medical service corporations, are required to cover these devices. This will likely lead to an increase in the availability and use of epinephrine auto-injectors among children, potentially reducing emergency health risks associated with anaphylactic reactions. By removing previous barriers such as prior authorization, the bill aims to make life-saving treatment quicker and more straightforward for parents and guardians to obtain in urgent situations.

Summary

Assembly Bill A504 mandates that all health insurers in New Jersey provide coverage for the purchase of epinephrine auto-injector devices for covered individuals aged 18 years or younger. This bill aims to enhance the accessibility of life-saving medication for children who may suffer from severe allergic reactions. As part of this legislation, the epinephrine auto-injector devices will be available without the need for prior authorization or any utilization management requirements, effectively streamlining the process for families in need of this essential medication.

Contention

While the bill has received support for its goal of protecting children's health, there is some discussion regarding the financial implications for insurers. Questions have arisen about how this mandate might affect insurance premiums and the overall cost structure for providers. Some critics argue that while aiming to protect children, the additional cost burden associated with ensuring guaranteed coverage for these devices could lead to increased premiums for all insured individuals. This creates a potential trade-off between public health objectives and the financial viability of insurance products.