Bills affecting Medicaid / public insurance in New Jersey (2026 session)

Requires health insurance and Medicaid coverage for family planning and reproductive health care services; prohibits adverse actions by medical malpractice insurers in relation to performance of legally protected health care services.

Requires unrestricted Medicaid coverage for ovulation enhancing drugs and medical services related to administering such drugs for certain beneficiaries experiencing infertility.

Requires Medicaid coverage for fertility preservation services in cases of iatrogenic infertility caused by medically necessary treatments.

Requires health insurance and Medicaid coverage for the treatment of stuttering.

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Establishes pilot program to provide Medicaid coverage of remote maternal health services for eligible beneficiaries.

Establishes minimum Medicaid reimbursement rates for certain ambulance transportation services.

Lowers minimum amount of uninsured and underinsured motorist coverage for transportation network companies and transportation network company drivers.

Requires health insurance and Medicaid coverage for testing and treatments to slow progression of Alzheimer's disease and related disorders.

Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.

Eliminates 16 hour per 24-hour period coverage limit on private duty nursing services for certain Medicaid enrollees who are 21 years of age or older.

Requires health insurance and Medicaid reimbursement of clinical laboratories regardless of managed care plan participation.

Increases resource threshold limit for certain Medicaid eligibility groups.

Increases personal needs allowance to $50 for recipients of Medicaid and Supplemental Security Income who are veterans or spouses of veterans and provides for annual cost-of-living increase in allowance.

Establishes minimum Medicaid and NJ FamilyCare reimbursement rate for pediatric special care nursing facilities.

Supplemental appropriation of $3.6 million to DHS to increase adult medical day care Medicaid per diem rate from $89.55 to $93.10.

"Mental Health Access Act;" increases Medicaid reimbursement rates for certain evidence-based behavioral health services.

Establishes minimum Medicaid reimbursement rates for private duty nursing services.

Requires Medicaid coverage for community violence prevention services; establishes training and certification program for violence prevention professionals.

Prohibits SHBP, SEHBP, and Medicaid from denying coverage for maintenance medications for chronic conditions for covered persons solely because of change in health benefits plan or pharmacy benefits manager.