Bill Text: NJ AR118 | 2016-2017 | Regular Session | Introduced
Bill Title: Urges U.S. Centers for Medicare & Medicaid Services and Congress to investigate practices involving direct and indirect remuneration fees and take appropriate steps to safeguard fairness and transparency.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2016-03-04 - Introduced, Referred to Assembly Health and Senior Services Committee [AR118 Detail]
Download: New_Jersey-2016-AR118-Introduced.html
Sponsored by:
Assemblyman PATRICK J. DIEGNAN, JR.
District 18 (Middlesex)
SYNOPSIS
Urges U.S. Centers for Medicare & Medicaid Services and Congress to investigate practices involving direct and indirect remuneration fees and take appropriate steps to safeguard fairness and transparency.
CURRENT VERSION OF TEXT
As introduced.
An Assembly Resolution urging the U.S. Centers for Medicare & Medicaid Services and Congress to investigate practices involving direct and indirect remuneration fees.
Whereas, Many small business independent community pharmacies in New Jersey are being assessed exorbitant fees, referred to as direct and indirect remuneration fees, or DIR fees, by health plans and pharmacy benefit managers; and
Whereas, There is no standardization or transparency regarding these DIR fees, which can vary widely and can include per-claim transaction fees as well as percentage-based fees assessed by health plans and pharmacy benefit managers at non-specific intervals for a variety of factors; and
Whereas, With no standardization or transparency to such DIR fees, independent community pharmacies being assessed these fees are often unaware of how such fees are determined or what the fees apply to, and the amount can significantly effect a small community pharmacy's operations and livelihood; and
Whereas, DIR fees are assessed after an independent community pharmacy adjudicates a claim and dispenses a medication, making it virtually impossible for independent pharmacy owners to determine what their actual reimbursement rate is; and
Whereas, It is the position of the New Jersey General Assembly that independent community pharmacies are a vital component of the State's "Main Street economy," and are health care providers on the front lines of patient care to the residents of New Jersey, and their services should be protected by ensuring a fair and transparent marketplace; and
Whereas, These New Jersey business owners and health care providers should not be burdened with non-transparent and extremely costly fee assessments without having a clear understanding of what fees will be assessed and at what time before the pharmacy dispenses a product; and
Whereas, A business owner should have access to all information necessary to know what reimbursement he or she will receive for a provided product or service at the outset of the contract, at the time of provision of the product or service, and at the end of the contractual term; now, therefore,
Be It Resolved by the General Assembly of the State of New Jersey:
1. The United States Centers for Medicare & Medicaid Services and the United States Congress are respectfully urged to investigate the practice of charging direct and indirect remuneration fees to independent community pharmacies, and to take necessary steps to ensure a fair and transparent business environment for the nation's small business owners and independent community pharmacies.
2. Copies of this resolution, as filed with the Secretary of State, shall be transmitted by the Clerk of the General Assembly to the Director of the United States Centers for Medicare & Medicaid Services, the Majority Leader and Minority Leader of the United States Senate, the Speaker and Minority Leader of the United States House of Representatives, and every member of the United States Congress elected from this State.
STATEMENT
This resolution urges the United States Centers for Medicare & Medicaid Services and Congress to investigate the practice of charging direct and indirect remuneration fees, or DIR fees, to independent community pharmacies, and to take necessary steps to ensure a fair and transparent business environment for the nation's small business owners and independent community pharmacies.
DIR fees are charged by health plans and pharmacy benefit managers to pharmacies in many different ways and in different amounts. These fees are not standardized, are often not transparent to independent community pharmacies that are obligated to pay them, and the amounts can significantly effect a small community pharmacy's operations and livelihood.
