Requires DOBI to review hormone replacement therapy coverage.

A4449

ASSEMBLY, No. 4449

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED FEBRUARY 24, 2026

Sponsored by:

Assemblywoman� HEATHER SIMMONS

District 3 (Cumberland, Gloucester and Salem)

SYNOPSIS

���� Requires DOBI to review hormone replacement therapy
coverage.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act

concerning the Department of Banking and
Insurance and hormone replacement therapy and supplementing P.L.2025, c.200
(C.17:48-6bbb et al.).

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

���� 1.��� a.� The Department of
Banking and Insurance shall conduct a confidential review of:

���� (1)�� the administration of
hormone replacement therapy coverage by health insurance carriers pursuant to
the �New Jersey Menopause Coverage Act,� P.L.2025, c.200 (C.17:48-6bbb et al.);
and

���� (2)�� pursuant to paragraph
(1) of this subsection, whether there is an aggregate increase in hormone
replacement therapy coverage by health insurance carriers after the effective
date of P.L.2025, c.200 (C.17:48-6bbb et al.).

���� b.��� For the purposes of
subsection a. of this act, the department shall review:

���� (1)�� data on prior
authorization and step therapy exception approvals and denials for hormone
replacement therapy coverage, as provided pursuant to section 17 of the
�Ensuring Transparency in Prior Authorization Act,� P.L.2023, c.296
(C.17B:30-55.16) and section 5 of P.L.2025, c.50 (C.30:4D-7yy); and

���� (2)�� other information, as
determined by the Commissioner of Banking and Insurance, from a health
insurance carrier that is gathered in the carrier�s ordinary course of
business.�

���� c.���� Conclusions of the
review conducted by the department pursuant to this section shall be transmitted
to the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), six
months after the effective date of P.L.��� , c.�� (C.������� ) (pending before
the Legislature as this bill).

���� 2.��� This act shall take
effect immediately and shall expire upon the submission of the department�s
conclusions of the review to the Legislature.

STATEMENT

���� This bill requires DOBI to
review hormone replacement therapy coverage provided by carriers pursuant to the
�New Jersey Menopause Coverage Act.�

���� Under the bill, DOBI will be
required to conduct a one-time confidential review to examine:

���� (1)�� the administration of
hormone replacement therapy coverage by health insurance carriers pursuant to
the �New Jersey Menopause Coverage Act;� and

���� (2)�� whether there is an
aggregate increase in hormone replacement therapy coverage by health insurance
carriers after enactment of that act.

���� The bill provides that the
department will review data on prior authorization and step therapy exception
approvals and denials that are available, as well as other information, as
determined by the department, from health insurance carriers as collected in
the carrier�s ordinary course of business.� The conclusions of the review
conducted by DOBI will be required to be transmitted to the Legislature six
months after this bill�s effective date.