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Bill > A4420


NJ A4420

NJ A4420
Requires health insurance carriers to provide list of alternative drugs to health care professionals, pharmacists, and covered persons under certain circumstances.


summary

Introduced
06/29/2022
In Committee
06/29/2022
Crossed Over
Passed
Dead
01/08/2024

Introduced Session

2022-2023 Regular Session

Bill Summary

This bill supplements the "Health Care Quality Act" to require a carrier that offers a health benefits plan in this State which provides coverage for pharmacy services, prescription drugs, or for participation in a prescription drug plan, to provide to a pharmacist in a situation in which the carrier denies a covered person's coverage for a drug prescribed by the health care professional, a list of all alternative drugs that are covered by the health benefits plan and that are interchangeable with, and therapeutically equivalent to, the drug for which coverage was denied. The carrier is to provide the list of alternative drugs to the pharmacy point of sale system at the time of denial, along with the notice of the denial of coverage along with the notice of the denial of coverage.

AI Summary

This bill supplements the "Health Care Quality Act" to require health insurance carriers that offer plans with prescription drug coverage to provide a list of alternative covered drugs that are interchangeable and therapeutically equivalent to any drug for which a covered person's coverage is denied. The carrier must provide this list to the pharmacist at the time of the coverage denial. The bill defines key terms like "health care professional," "carrier," and "pharmacist."

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 06/29/2022)

bill text


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