Bill > A4627

Introduced Session

This bill establishes requirements for patients to access emergency supplies of insulin and provides for insurance coverage of emergency insulin. Specifically, the bill requires the Department of Health (DOH) to maintain an adequate emergency stockpile of insulin as is necessary to meet the emergency needs of people in New Jersey whose insulin supply has or will run out before the person's next prescription may be filled. At a minimum, the emergency stockpile is include the 10 most common brands and types of insulin used by New Jersey residents. The DOH will be required to collaborate with the Commissioner of Banking and Insurance to determine which brands and types of insulin are most commonly used in New Jersey. In determining the quantity of insulin the DOH will need to maintain under the bill, the DOH will be required to take into account prevailing conditions in the State that may affect the need for and availability of insulin; take into account anticipated surges, over the next 90 days, in the need for emergency supplies of insulin; take into consideration the current state of the supply chain of insulin in the State, including, but not limited to, unit cost, recent price increases, overall availability, and delays in shipping times; and utilize any other tool as the DOH designates for use in determining the anticipated need for emergency insulin. The DOH will be required to reevaluate the adequacy of its emergency stockpile of insulin at least quarterly and acquire such additional supplies of insulin, and such additional brands and types of insulin, as it determines are necessary to meet the need for emergency insulin in New Jersey. The DOH will be required to develop a sourcing protocol to acquire insulin for its emergency stockpile that maximizes the cost effectiveness of the program and secures the best available consumer price for each insulin product. The DOH will be required to develop a program under which the DOH will furnish emergency insulin, at cost, to individuals whose insulin supply has or will run out before the person's next prescription may be filled. The DOH will be authorized to seek reimbursement for the emergency insulin from the person's health benefits plan, if any, or accept cash payment from the person. The department may establish standards and procedures to verify whether a person's insulin supply has or will run out before the person's next prescription may be filled. The bill additionally authorizes pharmacists to dispense an emergency 30-day supply of insulin once every 12 months, which emergency supply of insulin may be dispensed pursuant to a standing order issued by a prescriber or pursuant to the standing order issued by the DOH under the bill. In order to dispense emergency insulin to a person under the bill, the pharmacist will need to: have a record of a previous prescription for insulin for that person, which prescription was dispensed within the past year; have been unable to obtain authorization for an additional supply of insulin from an authorized prescriber; and ensure the amount of insulin dispensed in the emergency 30-day supply does not exceed the amount that was dispensed under the most recent prescription for insulin dispensed by the pharmacy to that person. The Commissioner of Health, or, if the commissioner is not a duly licensed physician, the Deputy Commissioner for Public Health Services, will be required to issue a standing order authorizing all licensed pharmacists in the State to dispense emergency insulin under the bill. The Commissioner of Health is to provide a copy of the standing order to the Board of Pharmacy, which will post a copy of the standing order on the board's Internet website and transmit a copy of the standing order to all licensed pharmacists in such a manner as the board deems appropriate. In general, individuals may not receive more than one emergency 30-day supply of insulin in a given 12-month period, regardless of whether the emergency insulin was dispensed by the DOH or a pharmacist. However, the bill authorizes the DOH to furnish additional emergency supplies of insulin to a person based on demonstrated need. The bill specifies that additional emergency supplies dispensed by the DOH over an emergency 30-day supply will not be subject to the insurance coverage requirements of the bill. The DOH and pharmacists will be required to report each emergency 30-day supply of insulin dispensed under the bill to the prescription monitoring database maintained pursuant to P.L.2007, c.244 (C.45:1-44 et al.) and will be required, prior to dispensing an emergency 30-day supply of insulin, to review the person's prescription monitoring information to determine whether the person was dispensed an emergency 30-day supply of insulin by the DOH or by a pharmacy in the preceding 12 months. The bill requires health insurers, Medicaid, the State Health Benefits Program, and the School Employees' Health Benefits Program to provide coverage for emergency 30-day supplies of insulin dispensed under the bill at least once every 12 months. The coverage requirement includes the health benefits plan of a hospital, medical or health service corporation, individual, small employer, large group commercial insurer, and health maintenance organization.

Committee Categories

Angela Mcknight (D)*,  Shanique Speight (D)*, 

Introduced, Referred to Assembly Health Committee (on 09/22/2022)

Official Document