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Bill > A5999


NJ A5999

NJ A5999
Prohibits pharmacy benefits managers from requiring covered persons to use mail service pharmacies.


summary

Introduced
11/25/2019
In Committee
11/25/2019
Crossed Over
Passed
Dead
01/08/2020

Introduced Session

2018-2019 Regular Session

Bill Summary

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.

AI Summary

This bill prohibits pharmacy benefits managers (PBMs) from requiring covered persons to use mail service pharmacies or automatically enrolling them in a mail service pharmacy program. PBMs may still offer mail service pharmacy options, but covered persons must be given the choice to use a non-mail service pharmacy and must consent in writing to using the mail service pharmacy. The bill aims to stop the practice of PBMs automatically enrolling covered persons in mail service pharmacy programs without their consent.

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 11/25/2019)

bill text


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