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N.J. Stat. § 52:14-17.29ll

State Health Benefits Commission, ensure, contract purchased, renewed, coverage, epinephrine auto-injector device

New Jersey · New Jersey Statutes Title 52 — State Government, Departments and Officers · Status: effective

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N.J. Stat. § 52:14-17.29ll, State Health Benefits Commission, ensure, contract purchased, renewed, coverage, epinephrine auto-injector device, New Jersey, version 1 as recorded 2026-09-28, yourstate.us, https://yourstate.us/provision/1478094
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26. The State Health Benefits Commission shall ensure that every contract purchased or renewed by the commission on or after the effective date of P.L.2023, c.105 (C.17:48-6xx et al.), shall provide coverage for at least one epinephrine auto-injector device, if recommended or prescribed by a participating physician or participating nurse practitioner/clinical nurse specialist. Coverage for the purchase of an epinephrine auto-injector device shall not be subject to any deductible, and no copayment or coinsurance for the purchase of an epinephrine auto-injector device shall exceed $25 per 30-day supply, except a contract provided by the State Health Benefits Commission that qualifies as a high-deductible health plan shall provide coverage for the purchase of an epinephrine auto-injector device at the lowest deductible and other cost-sharing requirement permitted for a high-deductible health plan under section 223(c)(2)(A) of the federal Internal Revenue Code (26 U.S.C. s.223 (c)(2)(A)). The provisions of this section shall apply to a plan that meets the requirements of a catastrophic plan, as defined in 45 C.F.R. s.156.155, to the maximum extent permitted by federal law. Nothing in this section shall prevent the State Health Benefits Commission from reducing a covered person's cost-sharing requirement by an amount greater than the amount specified in this section or prevent the commission from utilizing formulary management, including a mandatory generic policy, to promote the use of lower-cost alternative generic drugs that are the therapeutic equivalent of the brand-name drug, which could result in the member's copay being higher than set forth in this section.