Bill
Bill > S464
summary
Introduced
01/13/2026
01/13/2026
In Committee
01/13/2026
01/13/2026
Crossed Over
Passed
Dead
Introduced Session
2026-2027 Regular Session
Bill Summary
This bill establishes audit and payment requirements to be complied with by pharmacy benefit managers ("PBMs"). Under the bill, PBMs will be required to ensure that within 14 calendar days of receiving a pharmacy claim, (1) a claim is paid or reimbursed; or (2) notice is sent to the pharmacy in writing or electronically that the claim is contested or denied. Additionally, current law is amended to require annual audits of PBMs by the Department of Banking and Insurance.
AI Summary
This bill establishes new audit and payment requirements for pharmacy benefit managers (PBMs), which are companies that manage prescription drug benefits on behalf of health insurers or employers. Specifically, PBMs will be required to either pay or reimburse a pharmacy claim within 14 calendar days of receiving it, or provide written or electronic notification to the pharmacy if the claim is contested or denied. Additionally, the bill mandates annual audits of PBMs by the Department of Banking and Insurance, which will help ensure compliance with these new regulations and existing laws governing PBM operations.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee (on 01/13/2026)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2026/S464 |
| BillText | https://pub.njleg.gov/Bills/2026/S0500/464_I1.HTM |
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