Bill Text: NJ S3341 | 2018-2019 | Regular Session | Introduced
Bill Title: Regulates certain practices of pharmacy benefits managers related to specialty drugs; requires disclosure of payment information related to prescription drugs.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2019-01-17 - Introduced in the Senate, Referred to Senate Commerce Committee [S3341 Detail]
Download: New_Jersey-2018-S3341-Introduced.html
Sponsored by:
Senator JOSEPH P. CRYAN
District 20 (Union)
SYNOPSIS
Regulates certain practices of pharmacy benefits managers related to specialty drugs; requires disclosure of payment information related to prescription drugs.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning pharmacy benefits managers and supplementing P.L.2015, c.179 (C.17B:27F-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. A pharmacy benefits manager shall not require a pharmacy to purchase a specialty drug directly from the pharmacy benefits manager as a condition for participating in a pharmacy benefits manager's network contract or for any other reason.
b. For the purposes of this section, "specialty drug" means a prescription drug that:
(1) is prescribed for an individual with a complex, chronic, or rare medical condition;
(2) is available only from limited pharmacies;
(3) requires a difficult or unusual process of delivery to the patient in the preparation, handling, storage, inventory, or distribution of the drug; and
(4) requires enhanced patient education, management, or support, beyond those required for traditional dispensing.
2. a. A pharmacy benefits manager shall disclose to the Commissioner of Banking and Insurance, on a quarterly basis, for each prescription drug provided by the pharmacy benefits manager as part of the pharmacy benefits management services provided to purchasers of health benefits plans:
(1) the aggregate amounts paid by the pharmacy benefits manager to drug wholesalers or drug manufacturers for obtaining that drug;
(2) the aggregate amounts charged by the pharmacy benefits manager to purchasers for providing that drug to pharmacies; and
(3) the aggregate amounts paid by the pharmacy benefits manager to pharmacies for dispensing that drug.
b. The disclosures made pursuant to subsection a. of this section shall be made in a manner and format to be prescribed by the commissioner.
c. The commissioner shall make publicly available on the department's website, on at least an annual basis, a summary for each pharmacy benefits manager of the information disclosed pursuant to subsection a. of this section. The summary shall include, for each drug, the differences between the aggregate amounts paid or charged by the pharmacy benefits manager pursuant to paragraphs (1), (2), and (3) of subsection a. of this section.
3. This act shall take
effect on the 90th day next following enactment.
STATEMENT
This bill prohibits a pharmacy benefits manager from requiring a pharmacy to purchase a specialty drug, as defined in the bill, directly from the pharmacy benefits manager as a condition for participating in a pharmacy benefits manager's network contract or for any other reason.
The bill also requires pharmacy benefits managers to disclose to the Commissioner of Banking and Insurance, on a quarterly basis, for each prescription drug provided by the pharmacy benefits manager as part of the pharmacy benefits management services provided to purchasers of health benefits plans:
(1) the aggregate amounts paid by the pharmacy benefits manager to drug wholesalers or drug manufacturers for obtaining that drug;
(2) the aggregate amounts charged by the pharmacy benefits manager to purchasers for providing that drug to pharmacies; and
(3) the aggregate amounts paid by the pharmacy benefits manager to pharmacies for dispensing that drug.
The disclosures shall be made in a manner and format to be prescribed by the commissioner.
The bill also requires the commissioner to make publicly available on the department's website, on at least an annual basis, a summary for each pharmacy benefits manager of the information disclosed, including, for each drug, the differences between the aggregate amounts paid or charged by the pharmacy benefits manager.
