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215 Ill. Comp. Stat. § 134/72. Pharmacy providers: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
A health care plan shall apply the same co-insurance, copayment, and deductible factors to all drug prescriptions filled by a pharmacy provider that participates in the health care plan’s network. A health care plan may …
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30 Ill. Comp. Stat. § 105/14c. Prescription drug benefits: State Finance Act – Illinois
Status: Enacted     Year Enacted: 2004
No appropriation may be expended for prescription drug benefits under the State Employees Group Insurance Act of 1971 unless the benefit program allows all prescription drug benefits to be provided on the same terms and …
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63 Pa. Cons. Stat. § 390-8. Unlawful acts: Pharmacy Acts – Pennsylvania
Status: Enacted     Year Enacted: 1961
It shall be unlawful for any pharmacist to dispense an emergency prescription, unless the pharmacist does the specified. For example, the pharmacist must first attempt to obtain an authorization from the authorized prescriber and cannot …
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A 04888 – New York
Introduced: 2019    Status: Inactive / Dead    
Establishes and authorizes telepharmacy in this state; defines terms; creates telepharmacy satellite consultation sites and telepharmacy in hospitals; authorizes the filling of prescriptions at remote sites connected to central pharmacies via computer link, videolink and …

A 05969 – New York
Introduced: 2019    Status: Inactive / Dead    
Prohibits health insurers from requiring that the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar …

A 2214 (see companion bill S 2690; combined with A 3993) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
PROHIBITS PHARAMCY BENEFIT MANAGERS FROM COLLECTING COPAYMENTS IN EXCESS OF CERTAIN AMOUNTS “CLAWBACKS”; REQUIRES CERTAIN LANGUAGE PROHIBITNG “GAG CLAUSES” IN CONTRACTS WITH PHARMACISTS: Prohibits a pharmacy benefits manager, in connection with any contract or arrangement …

A 3007C – New York
Introduced: 2021    Status: Enacted    
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2021-2022 state fiscal year; extends the medicaid global cap; requires a quarterly report on certain medicaid …

A 3277 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REGULATES CERTAIN PRACTICES OF PHARMACY BENEFITS MANAGEMENT COMPANIES. The bill provides that a PBM shall not: (1) mandate that a covered person use a specific retail pharmacy, mail-order pharmacy, specialty pharmacy, or other pharmacy practice …

A 3717 (see companion bill S 728) – New Jersey
Introduced: 2018    Status: Enacted    
PROHIBITS PHARMACY BENEFIT MANAGERS FROM MAKING CERTAIN RETROACTIVE REDUCTIONS IN CLAIM PAYMENTS TO PHARMACIES:  After the date of receipt of a clean claim for payment made by a pharmacy, a pharmacy benefits manager shall not …

A 3993 (see companion bill S 2690; combined with A 2214) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
PROHIBITS PHARMACY BENEFIT MANAGERS FROM COLLECTING “CLAWBACK” COPAYMENTS; PROHIBITS “GAG CLAUSES” IN CONTRACTS WITH PHARMACISTS; PROVIDES CERTAIN PENALTES. A pharmacy benefits manager, in connection with any contract or arrangement with a private health insurer, prescription …

A 4041 (see ompanion bill S 2438) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
Would prohibit “gag clauses” by requiring a pharmacy benefits manager to include in any contract between the pharmacy benefits manager and a pharmacy in the State, language that permits the pharmacy to disclose to a …

A 5496 (see companion bill S 4210) – New Jersey
Introduced: 2019    Status: Inactive / Dead    
REQUIRES PHARMACY BENEFITS MANAGER UNDER CONTRACT WITH SHBP AND SEHBP TO REPORT PRICE PAID TO PHARMACY AND AMOUNT CHARGED TO SHBP AND SEHBP. This bill will requires a pharmacy benefit manager that has a contract …

A 5877 – New York
Introduced: 2021    Status: In Process    
Provides that prescription benefit plans may not require patients to receive prescriptions through mail order pharmacies.

A 5999 – New Jersey
Introduced: 2019    Status: Inactive / Dead    
Prohibits pharmacy benefits managers from requiring covered persons to use mail service pharmacies.

A 6409 – New York
Introduced: 2021    Status: In Process    
Requires managed care providers to annually provide each participant in their programs with a written list of mail-order pharmacies with which the managed care provider has a contract for coverage of prescription drugs.

A 7598 (see companion bill S 6603) – New York
Introduced: 2021    Status: Inactive / Dead    
Requires Medicaid managed care plans to reimburse retail pharmacies in an amount equal to the fee-for-service rate; allows retail pharmacies the opportunity to participate in another provider’s network under the medical assistance program; prohibits pharmacy …

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