New Jersey 222nd Legislature Status: Introduced Bipartisan · 1 R · 1 D cosponsors

S 374 — Requires health benefits coverage for treatment of lipedema.

Last action — REF SBA

  1. 1
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed General Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill has been introduced in the Senate. Introduced January 13, 2026. It must pass committee before a floor vote.

Next likely step: a committee referral and hearing.

Prognosis

Advancing 46% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • Introduced

    Current position in the legislative process.

  • 2 sponsors

    2 primary, 0 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (1 R · 1 D) — cross-party backing.

  • Cleared a recorded vote

    Passed 1 recorded vote so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

In plain language

Requires health insurance to cover treatment costs for lipedema.

This bill mandates that health insurance plans cover various treatments for lipedema, including surgeries and therapy. It also outlines the documentation required for coverage and prohibits denial based solely on submitted photographs.

What this means for you
  • Healthcare: This means more comprehensive treatment options for patients with lipedema.

Summary

Lipedema-require health benefits coverage for treatment

Bill Text

What changed in the latest version

209 added · 224 removed

Plain-language change summary

The amendment modifies the provisions regarding prior authorization for a lipectomy. It removes the requirement that prior authorization is valid for one year from the date received and instead aligns it with the requirements of the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296. This change impacts how prior authorizations are managed and emphasizes adherence to existing regulations rather than specifying a fixed duration for authorization validity.

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S374 SENATE, No.
S374 1R [First Reprint] SENATE, No.
374 STATE OF NEW JERSEY 222nd LEGISLATURE   PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION     Sponsored by:
374 STATE OF NEW JERSEY 222nd LEGISLATURE       Sponsored by:
  CURRENT VERSION OF TEXT      Introduced Pending Technical Review by Legislative Counsel.
  CURRENT VERSION OF TEXT      As reported by the Senate Commerce Committee on May 18, 2026, with amendments.
     c.    A hospital service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     c.     A hospital service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a hospital service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a hospital service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a hospital service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a hospital service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     c.    A medical service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     c.     A medical service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a medical service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a medical service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a medical service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a medical service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those medical service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those medical service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     c.    A health service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     c.     A health service corporation shall provide coverage for the total number of lipectomies deemed medically necessary by the subscriber’s surgeon and shall not require a subscriber’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the subscriber during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a health service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the subscriber’s surgeon receives the prior authorization and a health service corporation shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the subscriber continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a health service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the subscriber.  On receipt of information documenting a prior authorization from the subscriber or the subscriber’s surgeon, a health service corporation shall honor a prior authorization granted to a subscriber for a lipectomy by the subscriber’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
     c.    An individual health insurance policy shall provide coverage for the total number of lipectomies deemed medically necessary by the insured’s surgeon and shall not require an insured’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the insured during a lipectomy in order to receive coverage.
     c.     An individual health insurance policy shall provide coverage for the total number of lipectomies deemed medically necessary by the insured’s surgeon and shall not require an insured’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the insured during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the insured’s surgeon receives the prior authorization and an individual health insurance policy shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the insured continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the insured’s surgeon receives the prior authorization and an individual health insurance policy shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the insured continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the insured.  On receipt of information documenting a prior authorization from the insured or the insured’s surgeon, an individual health insurance policy shall honor a prior authorization granted to an insured for a lipectomy by the insured’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the insured.  On receipt of information documenting a prior authorization from the insured or the insured’s surgeon, an individual health insurance policy shall honor a prior authorization granted to an insured for a lipectomy by the insured’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those individual health insurance policies in which the individual health insurance policy has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those individual health insurance policies in which the individual health insurance policy has reserved the right to change the premium.
     c.    A group health insurance policy shall provide coverage for the total number of lipectomies deemed medically necessary by the insured’s surgeon and shall not require an insured’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the insured during a lipectomy in order to receive coverage.
     c.     A group health insurance policy shall provide coverage for the total number of lipectomies deemed medically necessary by the insured’s surgeon and shall not require an insured’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the insured during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the insured’s surgeon receives the prior authorization and a group health insurance policy shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the insured continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the insured’s surgeon receives the prior authorization and a group health insurance policy shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the insured continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the insured.  On receipt of information documenting a prior authorization from the insured or the insured’s surgeon, a group health insurance policy shall honor a prior authorization granted to an insured for a lipectomy by the insured’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the insured.  On receipt of information documenting a prior authorization from the insured or the insured’s surgeon, a group health insurance policy shall honor a prior authorization granted to an insured for a lipectomy by the insured’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those group health insurance policies in which the group health insurance policy has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those group health insurance policies in which the group health insurance policy has reserved the right to change the premium.
     c.    An individual health benefits plan shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     c.     An individual health benefits plan shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and an individual health benefits plan shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and an individual health benefits plan shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, an individual health benefits plan shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, an individual health benefits plan shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
     c.    A small employer health benefits plan shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     c.     A small employer health benefits plan shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a small employer health benefits plan shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a small employer health benefits plan shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a small employer health benefits plan shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a small employer health benefits plan shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.
     c.    A health maintenance organization shall provide coverage for the total number of lipectomies deemed medically necessary by the enrollee’s surgeon and shall not require an enrollee’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the enrollee during a lipectomy in order to receive coverage.
     c.     A health maintenance organization shall provide coverage for the total number of lipectomies deemed medically necessary by the enrollee’s surgeon and shall not require an enrollee’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the enrollee during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the enrollee’s surgeon receives the prior authorization and a health maintenance organization shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the enrollee continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the enrollee’s surgeon receives the prior authorization and a health maintenance organization shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the enrollee continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the enrollee.  On receipt of information documenting a prior authorization from the enrollee or the enrollee’s surgeon, a health maintenance organization shall honor a prior authorization granted to an enrollee for a lipectomy by the enrollee’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the enrollee.  On receipt of information documenting a prior authorization from the enrollee or the enrollee’s surgeon, a health maintenance organization shall honor a prior authorization granted to an enrollee for a lipectomy by the enrollee’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1 .
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.       f.     This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
     c.    A contract purchased by the commission shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     c.     A contract purchased by the commission shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a contract purchased by the commission shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a contract purchased by the commission shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a contract purchased by the commission shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a contract purchased by the commission shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.
     c.    A contract purchased by the commission shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
     c.     A contract purchased by the commission shall provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during a lipectomy in order to receive coverage.
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     d.    Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior authorization for a lipectomy shall be valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a contract purchased by the commission shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
     d.    1[Notwithstanding the provisions of any law, rule, or regulation to the contrary, prior] Prior1 authorization for a lipectomy shall be 1[valid for a period of one year from the date the covered person’s surgeon receives the prior authorization and a contract purchased by the commission shall not revoke, limit, condition, or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage;
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a contract purchased by the commission shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization.
and (3) there has not been a material change in the clinical circumstances or condition of the covered person.  On receipt of information documenting a prior authorization from the covered person or the covered person’s surgeon, a contract purchased by the commission shall honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization] in accordance with prior authorization requirements established pursuant to the “Ensuring Transparency in Prior Authorization Act,” P.L.2023, c.296 (C.17B:30-55.1 et al.)1.
     e.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.         11.  This act shall take effect on the first day of the sixth month next following enactment and shall apply to contracts entered into or renewed after that date.
     e.     The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract and shall be consistent with the current standard of care for lipedema.         11.  This act shall take effect on the first day of the sixth month next following enactment and shall apply to contracts entered into or renewed after that date.
    STATEMENT        This bill requires health insurers (health, hospital and medical service corporations, commercial individual and group health insurers;
health maintenance organizations, health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees’ Health Benefits Program) to provide coverage for expenses incurred for the treatment of lipedema.
The expenses for which coverage is to be provided include compression garments for all of the covered person’s affected extremities, manual lymphatic drainage, medical nutrition therapy, mental health care, lipectomy that is determined to be medically necessary by the covered person’s surgeon, and pre-and post-lipectomies appointments with the covered person’s physician and surgeon.
     The bill requires a covered person to provide a carrier with documentation from the covered person’s physician diagnosing the covered person with lipedema and, if applicable, documentation from the covered person’s surgeon that includes photographs of the covered person that support the diagnosis and information on the number of lipectomies the covered person’s surgeon deems medically necessary.
     Under the bill, a carrier is to provide coverage for the total number of lipectomies deemed medically necessary by the covered person’s surgeon and shall not require a covered person’s surgeon to remove less fat than the surgeon deems medically necessary to be removed from the covered person during lipectomy in order to receive coverage.
If a carrier denies coverage for expenses incurred for the treatment of lipedema, the carrier is to provide the covered person with a detailed explanation of the reason for the denial.  A carrier cannot deny coverage for expenses incurred for the treatment of lipedema solely based on photographs of the covered person submitted pursuant to the bill.
     Additionally, the bill provides that prior authorization granted by a carrier for a lipectomy is valid for a period of one year from the date the covered person’s surgeon receives the prior authorization.
A carrier is required to honor a prior authorization granted to a covered person for a lipectomy by the covered person’s previous carrier for the remainder of the duration of the prior authorization.  Coverage is to be provided consistent with the current standard of care for lipedema.
     Lipedema is a chronic, progressive condition characterized by abnormal and often painful fat accumulation in specific areas of the body.  The condition does not have a cure, but lipectomy can help remove fat and reduce the pain associated with the condition.
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Action History

  1. REF SBA

  2. REP/SCA 2RS

  3. INT 1RS REF SCM

Sponsors

Sponsorship breakdown

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2 sponsors · 0 co-sponsors · 118 not signed on

Sponsors (2)

Co-sponsors (0)

None.

Not signed on (118)

118 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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healthcare health-insurance
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Frequently asked questions

What does S 374 do?
Lipedema-require health benefits coverage for treatment
Who sponsors S 374?
S 374 is sponsored by Steinhardt, Douglas J. (Republican) and Ruiz, M. Teresa (Democrat).
What is the current status of S 374?
This bill has been introduced in the Senate. Introduced January 13, 2026. It must pass committee before a floor vote.
Where can I track S 374?
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