Sponsored by:
Senator THOMAS H. KEAN, JR.
District 21 (Morris, Somerset and Union)
Senator LINDA R. GREENSTEIN
District 14 (Mercer and Middlesex)
SYNOPSIS
Prohibits pharmacy benefits managers from requiring covered persons to use mail service pharmacies.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning pharmacy benefits managers and mail service pharmacies 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 pharmacy benefits manager, in connection with any contract or arrangement with a private health insurer, prescription benefit plan, or the State Health Benefits Program or School Employees' Health Benefits Program, shall neither require a covered person to use a mail service pharmacy nor automatically enroll a covered person in a mail service pharmacy program. A pharmacy benefits manager may provide benefits to a covered person through a mail service pharmacy, provided that the covered person is given the option to use the mail service pharmacy or a non-mail service pharmacy, and the covered person consents in writing to the use of the mail service pharmacy.
2. This act shall take effect on January 1, 2021.
STATEMENT
This bill prohibits pharmacy benefits managers from requiring covered persons to use mail service pharmacies. Specifically, the bill provides that pharmacy benefits managers, in connection with any contract or arrangement with a private health insurer, prescription benefit plan, or the State Health Benefits Program or School Employees' Health Benefits Program, may neither require covered persons to use a mail service pharmacy nor automatically enroll covered persons in a mail service pharmacy program. The bill provides that pharmacy benefits managers may provide benefits to covered persons through mail service pharmacies, provided that the covered persons are given the option to use a mail service pharmacy or a non-mail service pharmacy, and the covered persons consent in writing to the use of the mail service pharmacy.
It has come to the attention of the sponsor that certain pharmacy benefits managers in New Jersey automatically enroll covered persons in a mail service pharmacy program without the covered persons’ consent. This bill is intended to stop these automatic enrollments and to support the right of covered persons to use a non-mail service pharmacy if they so choose.