[First Reprint]

ASSEMBLY, No. 4338

STATE OF NEW JERSEY

217th LEGISLATURE

INTRODUCED NOVEMBER 21, 2016

Sponsored by:

Assemblyman  TROY SINGLETON

District 7 (Burlington)

Assemblywoman  JOANN DOWNEY

District 11 (Monmouth)

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 reported by the Assembly Financial Institutions and Insurance Committee on January 30, 2017, with amendments.

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 ¹[and speak with a New Jersey-licensed pharmacist]¹ to resolve issues pertaining to benefits coverage¹[,] or¹ drug pricing ¹[and] . Additionally, the pharmacy benefits manager shall make available a New Jersey licensed pharmacist to resolve issues related to¹ prescription drug safety.  ¹[Callers shall not be placed on hold for longer than five minutes.]¹ The pharmacy benefits manager shall ¹make a reasonable attempt to¹ 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.