Legislation


S 1765 – New Jersey

Status: Inactive / Dead
Year Introduced: 2020
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S1765

Requires pharmacy benefits manager providing services within Medicaid program to implement pass-through pricing model and to disclose certain information to DHS and managed care organizations. The bill requires a pharmacy benefits manager providing services within Medicaid program to implement a pass-through pricing model. As defined in the bill, a “pass-through pricing model” is a model in which a managed care organization reimburses the pharmacy benefits manager for prescription drugs at a rate equal to the amount paid by the pharmacy benefits manger to the pharmacy on behalf of the managed care organization, plus an administrative fee based on a predetermined metric, such as per prescription or per member. Additionally, the bill requires a pharmacy benefits manager to disclose certain information to the Department of Human Services and the applicable managed care organization. A similar law recently adopted in New York is projected to save the State at least $43 million in Medicaid dollars by ensuring that pharmacy benefits managers do not charge managed care organizations more for prescription drugs than what they actually pay to pharmacies.


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