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A4699
ASSEMBLY, No. 4699
STATE OF NEW JERSEY
222nd LEGISLATURE
�
INTRODUCED MARCH 16, 2026
Sponsored by:
Assemblywoman� SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Assemblyman� STERLEY S. STANLEY
District 18 (Middlesex)
SYNOPSIS
���� Requires health insurance carriers to cover genetic
testing after diagnosis of pancreatic cancer.
CURRENT VERSION OF TEXT
���� As introduced.
��
An Act
concerning genetic testing and pancreatic cancer
and supplementing various parts of the statutory law.
����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:
���� 1.��� a.� Every hospital
service corporation contract that provides hospital or medical expense benefits
and is delivered, issued, executed or renewed in this State pursuant to
P.L.1938, c.366 (C.17:48-1 et seq.), or approved for issuance or renewal in
this State by the Commissioner of Banking and Insurance on or after the
effective date of this act, shall provide benefits to any named subscriber or
other person covered thereunder for expenses incurred in conducting a genetic
test after diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all hospital service corporation contracts in which the
hospital service corporation has reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 2.��� a.� Every medical
service corporation contract that provides hospital or medical expense benefits
and is delivered, issued, executed or renewed in this State pursuant to P.L.1940,
c.74 (C.17:48A-1 et seq.), or approved for issuance or renewal in this State by
the Commissioner of Banking and Insurance on or after the effective date of
this act, shall provide benefits to any named subscriber or other person
covered thereunder for expenses incurred in conducting a genetic test after
diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all medical service corporation contracts in which the
medical service corporation has reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 3.��� a.� Every health service
corporation contract that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to P.L.1985,
c.236 (C.17:48E-1 et seq.), or approved for issuance or renewal in this State
by the Commissioner of Banking and Insurance on or after the effective date of
this act, shall provide benefits to any named subscriber or other person
covered thereunder for expenses incurred in conducting a genetic test after
diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� The provisions of this
section shall apply to all health service corporation contracts in which the health
service corporation has reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 4.��� a.� Every individual
policy that provides hospital or medical expense benefits and is delivered,
issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq.,
or approved for issuance or renewal in this State by the Commissioner of
Banking and Insurance on or after the effective date of this act, shall provide
benefits to any named insured or other person covered thereunder for expenses
incurred in conducting a genetic test after diagnosis of pancreatic
adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� The provisions of this
section shall apply to all health insurance policies in which the insurer has
reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 5.��� a.� Every group policy
that provides hospital or medical expense benefits and is delivered, issued,
executed or renewed in this State pursuant to N.J.S.17B:27-26 et seq., or
approved for issuance or renewal in this State by the Commissioner of Banking
and Insurance on or after the effective date of this act, shall provide benefits
to any named insured or other person covered thereunder for expenses incurred
in conducting a genetic test after diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
policy.
���� c.���� The provisions of this
section shall apply to all health insurance policies in which the insurer has
reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 6.��� a.� Every individual
health benefits plan that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to P.L.1992,
c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State on
or after the effective date of this act, shall provide benefits to any person
covered thereunder for expenses incurred in conducting a genetic test after
diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the health
benefits plan.
���� c.���� The provisions of this
section shall apply to all health benefits plans in which the carrier has
reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 7.��� a.� Every small employer
health benefits plan that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to P.L.1992,
c.162 (C.17B:27A-17 et seq.), or approved for issuance or renewal in this State
on or after the effective date of this act, shall provide benefits to any
person covered thereunder for expenses incurred in conducting a genetic test
after diagnosis of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the health
benefits plan.
���� c.���� The provisions of this
section shall apply to all health benefits plans in which the carrier has
reserved the right to change the premium.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 8.��� a.� Every enrollee
agreement that provides hospital or medical expense benefits and is delivered,
issued, executed, or renewed in this State pursuant to P.L.1973, c.337
(C.26:2J-1 et seq.), or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance on or after the effective date of this
act, shall provide health care services to any enrollee or other person covered
thereunder for expenses incurred in conducting a genetic test after diagnosis
of pancreatic adenocarcinoma.�
���� b.��� The health care services
shall be provided to the same extent as for any other medical condition under
the enrollee agreement.
���� c.���� The provisions of this
section shall apply to all enrollee agreements in which the health maintenance
organization has reserved the right to change the schedule of charges.
���� d.��� As used in this section,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.
���� 9.��� a.� The State Health
Benefits Commission shall ensure that every contract purchased by the
commission on or after the effective date of this act, that provides hospital
or medical expense benefits, shall provide benefits to any person covered
thereunder for expenses incurred in conducting a genetic test after diagnosis
of pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� As used in this
section, �genetic test� means a medical test to analyze an individual�s
deoxyribonucleic acid, ribonucleic acid, chromosomes, or proteins to identify
genetic changes or mutations associated with pancreatic adenocarcinoma and other
cancers and to guide monitoring, treatment decisions, and appropriate
management for individuals diagnosed with pancreatic adenocarcinoma.� �Genetic
testing� shall include but not be limited to germline testing and tumor
molecular profiling.
���� 10.� a.� The School Employees�
Health Benefits Commission shall ensure that every contract purchased by the
commission on or after the effective date of this act that provides hospital or
medical expense benefits shall provide benefits to any person covered thereunder
for expenses incurred in conducting a genetic test after diagnosis of
pancreatic adenocarcinoma.�
���� b.��� The benefits shall be
provided to the same extent as for any other medical condition under the
contract.
���� c.���� As used in this
section, �genetic test� means a medical test to analyze an individual�s
deoxyribonucleic acid, ribonucleic acid, chromosomes, or proteins to identify
genetic changes or mutations associated with pancreatic adenocarcinoma and other
cancers and to guide monitoring, treatment decisions, and appropriate
management for individuals diagnosed with pancreatic adenocarcinoma.� �Genetic
testing� shall include but not be limited to germline testing and tumor
molecular profiling.
���� 11.� This act shall take
effect on the first day of the fourth month next following the date of enactment
and shall apply to policies and contracts that are delivered, issued, executed,
or renewed on or after that date.
STATEMENT
���� This bill requires health
insurance carriers to cover genetic testing after a diagnosis of pancreatic
cancer.
���� Under the bill, health
insurance carriers (including health service corporations, hospital service
corporations, medical service corporations, health maintenance organizations
authorized to issue health benefits plans in New Jersey, and entities
contracted to administer health benefits in connection with the State Health
Benefits Program or School Employees� Health Benefits Program) will be required
to cover a genetic test after a covered person is diagnosed with pancreatic
adenocarcinoma.�
���� For the purposes of this bill,
�genetic test� means a medical test to analyze an individual�s deoxyribonucleic
acid, ribonucleic acid, chromosomes, or proteins to identify genetic changes or
mutations associated with pancreatic adenocarcinoma and other cancers and to
guide monitoring, treatment decisions, and appropriate management for
individuals diagnosed with pancreatic adenocarcinoma.� �Genetic testing� shall
include but not be limited to germline testing and tumor molecular profiling.