Assembly committee advances menopause coverage and physician-education bills

The Assembly Health Committee on a voice/roll-call vote released two companion bills that would require insurance coverage for medically necessary perimenopause and menopause treatments and permit continuing medical education (CME) credits for physicians on menopause.

Assemblywoman Simpson, sponsor of A5278 and A5309, told the committee the package responds to widespread underdiagnosis and undertreatment of menopause. "This bill package came from lying in my bed in the middle of the night with insomnia, unable to sleep, anxiety, and night sweats ... And thinking to myself that as a country, as a state, we can do better," she said.

The bills: A5278, titled the New Jersey Menopause Coverage Act, would require health insurance coverage of medically necessary perimenopause and menopause treatments; committee amendments revise the definition of menopause. A5309 would permit up to three CME credits on menopause for physicians to use toward license renewal; committee amendments corrected numbering and increased optional credits from one to three.

Committee members praised the focus but probed details. Assemblywoman Munoz asked whether validated CME courses already exist and why a statutory provision was needed. Simpson responded that menopause training is available but often not listed in the continuing-education menus and that the provision is intended to raise awareness rather than mandate training. "To bring attention to it and to say that this is available to physicians, but not require physicians to do it, is important," Simpson said.

Members also raised scope and coverage questions. One member asked whether advanced practice nurses and other nonphysician providers should be specifically included; Simpson said she had discussed that with an advanced practice nurse and had additional amendments addressing provider inclusion. The committee also discussed how insurers will code and cover treatments and noted that some mental-health services and some treatments already have existing coverage under New Jersey carriers.

The committee recorded roll-call votes releasing A5278 and A5309 as amended. Members who voted yes included Assemblymen Rumpf, Peterson, Brelli, Tully and Assemblywomen Munoz, Kane, Hader, Begoli and Chairwoman Murphy. The bills move from committee with the committee amendments described on the record.

Funding, implementation and precise coverage details—such as which hormone formulations or supplements would be reimbursed and how insurers will interpret code-based coverage—were identified as matters for follow-up with carriers and through the amendment process.

The committee also received in‑record supportive slips from the New Jersey section of the American College of Obstetricians and Gynecologists for both bills; representatives did not testify in person.

The committee chair said both bills will be returned to the full Assembly with the committee amendments.