Establishes certain guidelines for SHBP, SEHBP, and Medicaid concerning step therapy protocols.

This bill (A1825) establishes guidelines for health insurance plans regarding "step therapy" protocols, which require patients to try lower-cost medications before coverage is provided for a preferred medication selected by their doctor. It requires insurers to base these protocols on clinical guidelines developed by expert panels with conflict-of-interest safeguards, and creates a clear process for patients to request exceptions when step therapy would be harmful or ineffective. Insurers must grant or deny exception requests within 72 hours (24 hours in emergencies), and must report on exception requests and outcomes to the state insurance commissioner. This affects all health insurance carriers in New Jersey, including those offering SHBP, SEHBP, and Medicaid plans, as well as the patients and healthcare providers who use these plans.