Bill Text: NJ A3447 | 2012-2013 | Regular Session | Introduced
Bill Title: Requires fee-for-service Medicaid prescription drug benefits for Medicaid recipients not eligible for Medicare.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2012-11-19 - Introduced, Referred to Assembly Health and Senior Services Committee [A3447 Detail]
Download: New_Jersey-2012-A3447-Introduced.html
Sponsored by:
Assemblyman ALBERT COUTINHO
District 29 (Essex)
SYNOPSIS
Requires fee-for-service Medicaid prescription drug benefits for Medicaid recipients not eligible for Medicare.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid prescription drug benefits and supplementing P.L.1968, c.413 (C.30:4D-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Prescription drug benefits under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), for individuals who are not eligible for the Medicare program established pursuant to Title XVIII of the federal Social Security Act, Pub.L.89-97 (42 U.S.C. s.1395 et seq.) shall be provided on a fee-for-service basis based upon reimbursement formulas established by the Commissioner of Human Services and shall not be included in a managed care plan offered in this State to Medicaid recipients.
b. Commencing on the first day of the second month following the effective date of this act, the Commissioner of Human Services shall forward on a monthly basis, to each insurance company, health, hospital, or medical service corporation, or health maintenance organization that offers a managed care plan to Medicaid recipients in this State, the following information with respect to prescription drug usage during the preceding month for each Medicaid recipient enrolled in that plan who is not eligible for Medicare: (1) the name of each drug prescribed for that person, (2) the prescribed dosage, (3) the dosage dispensed, and (4) the name and federal Drug Enforcement Administration registration number of the prescriber who prescribed the drug.
2. This act shall take effect on the first day of the third month next following the date of enactment.
STATEMENT
This bill requires that Medicaid prescription drug benefits for individuals who are not dually eligible for Medicare and Medicaid be provided on a fee-for-service basis, which would be based on reimbursement formulas established by the Commissioner of Human Services, and prohibits the inclusion of these benefits in a managed care plan offered in this State to Medicaid recipients.
The bill also provides that, commencing on the first day of the second month following its effective date, the Commissioner of Human Services is to forward on a monthly basis, to each insurer that offers a managed care plan to Medicaid recipients in this State, the following information with respect to prescription drug usage during the preceding month for each individual who is not dually eligible for Medicare and Medicaid enrolled in that plan: the name of each drug prescribed for that person, the prescribed dosage, the dosage dispensed, and the name and federal Drug Enforcement Administration registration number of the prescriber who prescribed the drug.
