SENATE, No. 2060

STATE OF NEW JERSEY

218th LEGISLATURE

 

INTRODUCED FEBRUARY 26, 2018

 


 

Sponsored by:

Senator  LINDA R. GREENSTEIN

District 14 (Mercer and Middlesex)

 

 

 

 

SYNOPSIS

     “Prescription Drug Consumer Transparency Act;” requires pharmacy benefits managers to disclose certain information to benefit plan purchasers and to establish toll-free telephone number for certain inquiries.

 

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.         This act shall be known as the “Prescription Drug Consumer Transparency Act.”

 

     2.    If requested by the purchaser at the time of contracting, a pharmacy benefits manager shall disclose in the contract between the pharmacy benefits manager and the purchaser each of the following:

     a.     The basis of the methodology and sources utilized to establish multiple source generic pricing.  Applicable lists shall be updated and provided to the purchaser upon request whenever there is a change;

     b.    If a pharmacy benefits manager utilizes a multiple source generic list for drugs dispensed at retail, but does not utilize a similar list for drugs dispensed by mail.  This practice shall be disclosed to the purchaser in writing either in the contract or no later than 21 business days from the implementation of the practice; and

     c.     Whether or not the pharmacy benefits manager is using the identical multiple source generic drug list with respect to billing the purchaser as it does when reimbursing all network pharmacies.  If multiple source generic drug lists are used, the pharmacy benefits manager shall disclose whether there was any difference between the amount paid to any pharmacy and the amount charged to the purchaser.

 

     3.    A pharmacy benefits manager shall provide a toll-free telephone number through which a contracted pharmacy or a consumer may contact the pharmacy benefits manager to resolve issues pertaining to benefits coverage or drug pricing.  Additionally, the pharmacy benefits manager shall make available a New Jersey licensed pharmacist to resolve issues related to prescription drug safety.  The pharmacy benefits manager shall make a reasonable attempt to resolve concerns within 24 hours of receiving the inquiry.

 

     4.    This act shall take effect on the 90th day next following enactment and shall apply to all contracts or agreements for pharmacy benefits management services that are executed or renewed on or after the effective date.

STATEMENT

 

     This bill supplements P.L.2015, c.179 (C.17B:27F-1 et seq.) by requiring pharmacy benefits managers (PBMs) to disclose certain information about prescription drug pricing and generic substitutions to benefit plan purchasers.  The bill also requires PBMs to establish a toll-free telephone number through which consumers and pharmacists can quickly obtain information regarding coverage, pricing and prescription drug safety.

     At the time of contracting between a purchaser of pharmacy benefits management services and a PBM, if the purchaser requests the basis of the methodology and sources utilized to determine multiple source generic drug pricing, the bill requires PBMs to disclose that information in the contract. That pricing information shall be updated whenever a change occurs and be provided to the purchaser upon request.  If a PBM uses a multiple source generic list for drugs dispensed at retail, but not for drugs dispensed by mail, this must be disclosed in the contract as well, or within 21 business days from the implementation of the practice. 

     In addition, the bill requires PBMs to disclose to purchasers whether the multiple source generic pricing list used to bill the purchaser is the same as the list used to reimburse all network pharmacies.  If multiple source generic drug pricing lists are used, the PBM must disclose whether there was any difference between the amount paid to any pharmacy and the amount charged to the purchaser.

     This bill also requires PBMs to provide a toll-free telephone number for contracted pharmacies and consumers to contact the PBM to resolve issues pertaining to benefits coverage or drug pricing.  Additionally, the pharmacy benefits manager shall make available a New Jersey-licensed pharmacist to resolve issues related to prescription drug safety.  The PBM must make a reasonable attempt to resolve concerns within 24 hours of receiving the inquiry.