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.

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

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

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 rates for certain ambulance transportation services.

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

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.

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

Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.

Requires Medicaid reimbursement of mental health rehabilitation services provided via clubhouse program.

Requires health insurance carriers and Medicaid to provide coverage for planned home childbirth.

Prohibits incarcerated individuals from receiving Medicaid, Work First New Jersey, or Supplemental Nutrition Assistance Program benefits.

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

Increases cap on personal care assistant services from 40 hours to 91 hours per week for Medicaid beneficiary determined clinically eligible for nursing facility level of care.

Requires Medicaid and health insurance network contracts to provide participating health care providers with certain notifications.

Establishes minimum Medicaid and NJ FamilyCare pediatric special care nursing facility reimbursement rates.

Amends law to extend length of postpartum coverage for Medicaid services for eligible pregnant women to 180-day period.

Requires Medicaid coverage for continuous glucose monitors and related supplies for individuals diagnosed with diabetes who meet certain coverage eligibility criteria.