Bill > S4698

This bill amends existing New Jersey law to explicitly require pharmacy benefits managers (PBMs) to have a fiduciary duty to the financial interests of covered persons, in addition to their existing responsibilities to health insurance carriers. Specifically, the bill mandates that PBMs must now prioritize the financial interests of patients above the interests of the health insurance carriers they contract with, while maintaining their existing duties of good faith and fair dealing. The legislation reinforces existing requirements for carriers to monitor PBM activities related to prescription drug benefits and ensures that all funds received by PBMs are used or distributed according to their contracts or applicable law. The bill also maintains provisions that prevent carriers or PBMs from requiring patients to pay more at the point of sale for a prescription drug than the applicable cost-sharing amount or the cash price of the medication. The new requirements will apply to all health benefits plans, including state employee plans, Medicaid, and self-insured plans, and will take effect 180 days after enactment, applying to all contracts and policies delivered, issued, executed, or renewed after that date.

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https://www.njleg.state.nj.us/bill-search/2024/S4698