Jan. 31, 2024
OCEAN TOWNSHIP, NJ - Senator Vin Gopal (D-Monmouth) announced that the governor has signed into law legislation updating the requirements and standards for prior authorization of medicines and health services to patients.
The new law will streamline the process of getting prior approval and rulings on denial appeals from insurance carriers and other healthcare providers, including the State Health Benefits Program and School Employees’ Health Benefits Program.
The bill, S1794, was signed into law during the final days of the last legislative session with bi-partisan support and was co-sponsored by Senator Robert Singer (R-Monmouth and Ocean). The legislation sets standards that ensure the doctors who review prior approval requests or denial appeals for insurance carriers have a background in the treatment being requested and the condition it addresses.
“Prior authorization plays an important role in making sure patients receive the correct treatments,” Gopal said. “This new law will help patients get the right treatment or medications faster while maintaining the direct decision-making relationship between the patient and physician about the best course of treatment. It also enhances the transparency of the approval or denial process by requiring utilization review entities, which approve or deny the request, to disclose their prior authorization requirements and restrictions on their website and in writing.”
Senator Vin Gopal, a lifelong resident of Monmouth County elected in 2018, serves as Senate Majority Conference Leader and Chair of the Senate Education Committee. Assemblywoman Dr. Margie Donlon, a practicing physician, serves on the Assembly Health and the Tourism, Gaming & the Arts Committees; Assemblywoman Luanne Peterpaul, Esq., serves on the Assembly Commerce, Economic Development & Agriculture and the Aging & Human Services Committees. They represent residents of Asbury Park, Allenhurst, Bradley Beach, Colts Neck, Deal, Eatontown, Fair Haven, Freehold, Freehold Township, Interlaken, Loch Arbor, Long Branch, Neptune City, Neptune Township, Ocean Township, Red Bank, Tinton Falls, Shrewsbury, Shrewsbury Township, and West Long Branch in the State Senate.