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Bill

A 1142

Expands requirements for health insurance carriers concerning prostate cancer screening. *

2026-2027 Regular Session Introduced by Rosy Bagolie and 30 co-sponsors

Expands no-cost annual prostate cancer screening across private, public, and school plans to follow latest clinical guidelines.

Reported out of Asm. Comm. with Amendments, and Referred to Assembly Appropriations Committee
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Bill Summary · A 1142

Summary of New Jersey Bill A-1142 (Session 222)

1) Purpose and intent

  • The bill expands health insurance requirements to ensure coverage for annual prostate cancer screening across various types of health plans and public programs, with no cost-sharing (i.e., no deductibles, co-pays, or coinsurance).
  • It directs that screening be provided in line with the latest nationally recognized clinical practice guidelines.
  • The measure aims to improve access to preventive screening for prostate cancer and aligns private plans, public plans, and state employee/education-related health benefits with uniform screening standards.

2) Key provisions and changes

A. Private plans (Sections 1-4)

  • Applies to multiple types of health coverage:
    • Health service corporations (Section 1)
    • Hospital service corporations (Section 2)
    • Medical service corporations (Section 3)
    • Group health insurance policies (Section 4)
    • Each type covers plans delivered, issued, or renewed in NJ and with premium-change rights reserved by the insurer.
  • Core requirement for all such contracts:
    • Prohibit any cost-sharing for annual prostate cancer screening.
    • Screening must be conducted in accordance with the latest nationally recognized clinical practice guidelines.
  • Scope includes various plan formats, including high-deductible plans, HSAs, and catastrophic plans to the extent permitted by federal law.
  • Definition required: “Nationally recognized clinical practice guidelines” are evidence-based standards from independent organizations or medical societies, using transparent methodologies and conflict-of-interest policies.

B. New standalone coverage mandates (Sections 6-8)

  • Section 6: Individual health insurance policies under Chapter 26 of Title 17B
    • All such policies delivered or renewed on/after the act’s effective date must cover annual prostate cancer screening with no cost-sharing.
  • Section 7: Individual health benefits plans under chapter 27A (C.17B:27A-2 et seq.) or related to 1992 law
    • Similar annual screening coverage with no cost-sharing; applies to plans with premium-change rights and to high-deductible plans as federal law allows.
  • Section 8: Small employer health benefits plans (Chapter 162)
    • Requires annual prostate cancer screening coverage with no cost-sharing; applies to plans with premium-change rights and to high-deductible plans consistent with federal law.

C. State and public-sector health benefits (Sections 9-10)

  • Section 9: State Health Benefits Commission contracts
    • All contracts entered into or renewed on/after the act's effective date must provide annual prostate cancer screening with no cost-sharing.
  • Section 10: School Employees’ Health Benefits Commission
    • Same requirement for all contracts issued or renewed on/after the act’s effective date.

D. Effective date and transition (Section 11)

  • General effective date: 90 days after enactment.
  • Applicability: Most contracts/policies delivered or renewed on or after that date.
  • Special note: Section 7 (pertaining to certain health benefit plans) takes effect for policies and contracts delivered/issued/renewed on January 1, 2027.

3) Who and what is affected

  • Private insurers and insurers’ contracts across multiple product lines (health service, hospital service, medical service, group health policies).
  • Individual health insurance policies and health benefits plans (including high-deductible and catastrophic plans, to the extent federal law allows).
  • State-administered plans:
    • State Health Benefits Commission contracts
    • School Employees’ Health Benefits Commission contracts
  • All covered individuals under these plans will have annual prostate cancer screening covered with no cost-sharing.

4) Procedural and timeline aspects

  • Effective date: 90 days after enactment.
  • Broad applicability to contracts/policies issued or renewed on/after the effective date, with a specific synchronization for some sections (Section 7) to January 1, 2027.
  • Uses “latest nationally recognized clinical practice guidelines” to define screening standards (no specific guideline version is enumerated; updates will guide coverage).

5) Definitions and standards

  • The bill defines “Nationally recognized clinical practice guidelines” as evidence-based, developed by independent organizations or medical societies, with transparent methodologies, reporting structures, and conflict-of-interest policies.
  • Guidelines must reflect a systematic review of evidence and assess benefits/risks of alternatives to optimize patient care.

This bill would significantly expand and standardize no-cost prostate cancer screening coverage across private, public, and school-related health plans in New Jersey, anchored to current clinical guidelines.

Compiled from official sources — confirm details with the bill’s official record.

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