On July 15, 2012, the State of New Jersey passed a law that requires health insurance carriers to provide ?coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells? at the same benefit level or better than intravenous (IV) or injectable chemotherapy drugs. This mandate applies to AmeriHealth New Jersey HMO, PPO, Small Employer Health (SEH), 51+, and individual health coverage (IHC) plans. When prescribing oral anticancer medications to an AmeriHealth New Jersey member, you must first determine if the member has prescription drug coverage. Then follow these instructions: For members who have prescription drug coverage and use an in- or out-of-network pharmacy. Members who have prescription drug coverage through AmeriHealth New Jersey are eligible for oral anticancer medications to be covered at 100 percent. Cost-sharing (e.g., deductibles, copayments, or coinsurance) does not apply. For members who do not have prescription drug coverage. For AmeriHealth New Jersey members who do not have any prescription drug coverage, orally administered anticancer medications will be covered under their medical benefits at the same benefit level as IV or injectable chemotherapy drugs and supplied through the Direct Ship Injectables Program. To request orally administered anticancer medications for your patients, complete the Direct Ship Injectable Form located on our website at []www.amerihealth.com/directship []. Any claims submitted for reimbursement for orally administered anticancer medications will result in a denial message. Orally administered anticancer medications are covered under the member?s medical benefits only when the patient does not have prescription drug coverage. Please note that for this mandate, the pharmacy benefit is primary over the medical benefit at all times. If you have any questions about this mandate, please contact your Network Coordinator or call Customer Service at []1-800-275-2583[].