Bill
A 4628
Requires health insurance plans in New Jersey to cover continuous glucose monitoring systems for glycogen storage disease, to the same extent as coverage for other medical conditio
Note on inconsistency
- The bill number and public record you provided list the title as relating to motion‑picture theaters and open captioning, but the full text/version you pasted is a different bill: a health‑insurance mandate requiring coverage of continuous glucose monitoring systems for the treatment of glycogen storage disease. Because the body of the bill text is the substantive material provided, the summary below covers that health‑coverage measure (the introduced/printed A4628/A version), not the open‑captioning theater subject.
Summary — A4628 (printed A4628A) — Required insurance coverage of continuous glucose monitoring systems for glycogen storage disease
Purpose and intent
- Require that a wide range of health insurance contracts and public employer health plans delivered, issued, renewed, or approved in New Jersey provide coverage for expenses incurred in the purchase and use of continuous glucose monitoring (CGM) systems when prescribed by a health care practitioner to treat glycogen storage disease (GSD).
- Ensure parity by directing that CGM coverage be provided to the same extent as coverage for other medical conditions under the relevant contract or plan.
Key provisions
- Mandates coverage for CGM systems for treatment of glycogen storage disease across multiple product types, when issued, delivered, executed or renewed in NJ on or after the act’s effective date:
- Hospital service corporation contracts (P.L.1938, c.366; C.17:48‑1 et seq.)
- Medical service corporation contracts (P.L.1940, c.74; C.17:48A‑1 et seq.)
- Health service corporation contracts (P.L.1985, c.236; C.17:48E‑1 et seq.)
- Individual and group health insurance policies (N.J.S.17B:26‑1 et seq.; N.J.S.17B:27‑26 et seq.)
- Individual and small employer health benefits plans (P.L.1992, c.161; P.L.1992, c.162)
- Health maintenance organization (HMO) contracts (P.L.1973, c.337; C.26:2J‑1 et seq.)
- Contracts purchased by the State Health Benefits Commission and the School Employees’ Health Benefits Commission
- Each required coverage provision specifies benefits shall be provided “to the same extent as for any other medical condition” under the contract/plan.
- Several sections state the requirement applies to contracts in which the insurer/ corporation/plan “has reserved the right to change the premium” (i.e., to plans with reserved premium‑change provisions).
- The bill requires coverage “as prescribed by a health care practitioner” (medical necessity/presciber directive).
- Effective date language in the copy provided is truncated; the draft begins “This act shall take effect on the first day of the seventh month next following...” (full effective date should be confirmed in the final printed/recodified version).
Who is affected
- Insurers, HMOs, medical/health/hospital service corporations, and carriers issuing affected policies in New Jersey.
- Employers and public entities that purchase health plans through the State Health Benefits Commission and the School Employees’ Health Benefits Commission.
- Patients with glycogen storage disease who may benefit from CGM systems (improved glucose monitoring and management).
- Potentially impacts premium setting and plan costs for carriers and purchasers.
Procedural / timeline notes
- Introduced in the Assembly: June 25, 2024; Referred to Assembly Financial Institutions and Insurance Committee.
- Subsequent referrals: Consumer Affairs and Protection (Feb 4, 2025); printed as A4628A and amended May 2, 2025; reported and referred to Codes on May 6, 2025.
- Companion/related bills: S‑2757 and S‑2269 (Senate companions) and prior‑session A‑9947.
Potential impacts
- Expands mandated benefits and access to CGM technology for a specific rare metabolic condition (GSD), potentially improving patient outcomes and hypoglycemia/hyperglycemia management for affected individuals.
- May increase short‑term utilization of CGMs and related supplies; could influence insurer costs and therefore premium rates over time.
- Aligns CGM coverage for GSD with broader trends requiring coverage of diabetes‑related technologies and remote monitoring tools, but focuses specifically on glycogen storage disease.
If you intended the motion‑picture open‑captioning bill instead, please provide that text or confirm and I will prepare a summary of that measure.
Compiled from official sources — confirm details with the bill’s official record.
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