Bill > A4810

Introduced Session

This bill requires the NJ FamilyCare program to provide reimbursement for comprehensive medication management (CMM) services when provided by a licensed clinical pharmacist for a medically complex pediatric patient. "CMM services" is defined as a standard of care by which a clinical pharmacist assesses each of a patient's medications, including prescription and nonprescription medications, vitamins, and nutritional supplements, to determine that each is appropriate, effective, and safe, given the patient's medical conditions, comorbidities, and other medications. Comprehensive medication management services are provided by a clinical pharmacist as part of a patient's health care team. The bill defines a "clinical pharmacist" as a licensed pharmacist who has completed a clinical residency to acquire expertise in the therapeutic use of medications to ensure optimal patient health outcomes. Clinical pharmacists work as part of a patient's team of healthcare professionals to provide medication therapy evaluations and recommendations to patients and healthcare providers. CMM services for which a clinical pharmacist would receive NJ FamilyCare reimbursement will include:1. comprehensive reviews of a pediatric patient's prescription medications, over-the-counter medications, vitamins, and nutritional supplements;2. development and implementation of patient-specific medication action plans;3. ongoing monitoring of patient adherence to the patient-specific medication action plan;4. follow-up consultations and services necessary to ensure the efficacy and safety of the patient-specific medication action plan; and5. any other CMM services deemed necessary by the Division of Medical Assistance and Health Services (the division) in the Department of Human Services and the Board of Pharmacy for the appropriate care of a medically complex pediatric patient. The bill directs the division to enter into value-based contracts with licensed clinical pharmacists in order to reimburse for CMM services provided for medically complex pediatric patients. The division also will establish a quality assurance program in order to monitor and evaluate the outcomes and efficacy of the CMM services provided, and ensure that these services align with the division's value-based payment strategies. The division and the New Jersey State Board of Pharmacy in the Division of Consumer Affairs will designate the educational, training, and credentialing requirements for licensed clinical pharmacists to provide CMM services. The bill also amends "The New Jersey Pharmacy Practice Act," P.L.2003, c.280 (C.45:14-40 et seq.), to specify that a licensed clinical pharmacist who satisfies the credentialing requirements for the provision of CMM services will not be required to enter into a written agreement with a licensed physician in order to provide CMM services. The bill further amends section 25 of P.L.2003, c.280 to provide that the statutory provisions regulating collaborative drug therapy management will not apply to the provision of CMM services, as provided by a licensed clinical pharmacist.

Committee Categories

Reginald Atkins (D)*,  Lou Greenwald (D)*,  Shanique Speight (D)*,  Margie Donlon (D),  Luanne Peterpaul (D), 

Reported and Referred to Assembly Appropriations Committee (on 02/13/2025)

Official Document