Bill
Bill > A4005
NJ A4005
NJ A4005Provides for procurement by State of pharmacy benefits manager, automated reverse auction services, and claims adjudication services.
summary
Introduced
02/05/2026
02/05/2026
In Committee
02/05/2026
02/05/2026
Crossed Over
Passed
Dead
Introduced Session
2026-2027 Regular Session
Bill Summary
This bill provides that the State will procure, in an expedited manner, professional services contracts for: technical assistance to evaluate the qualifications of bidders on a pharmacy benefits manager procurement and online automated reverse auction services to support comparison of the pricing for the pharmacy benefits manager procurement; real-time, electronic, line-by-line, claim-by-claim review of invoiced pharmacy benefits manager pharmacy claims using an automated claims adjudication technology platform that allows for online comparison of pharmacy benefits manager invoices and auditing of other aspects of the services provided by the pharmacy benefits manager; and a pharmacy benefits manager for the State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP). The bill authorizes the Division of Purchase and Property in the Department of the Treasury, to the extent necessary, to waive or modify any other law or regulation that may interfere with the procurement of these services. Following the award of the pharmacy benefits manager contract, the bill requires the division to publish a report summarizing the results of the reverse auction, the realized savings resulting from the procurement of the required services required, any procedural deviations taken by the division during the procurement process, and any information deemed necessary by the division to increase accountability and oversight within 60 days. The bill will take effect immediately and expire after the next pharmacy benefits manager contract is awarded. In 2016, a similar law was enacted under P.L.2016, c.67, which required the division to hire a claims adjudication auditing firm and adopt a reverse auction process for the purposes of contracting with a pharmacy benefits manager for the SHBP or the SEHBP. As a result, the Department of the Treasury reported an estimated $40 million in savings for the SHBP in Fiscal Year 2017.
AI Summary
This bill authorizes the State to quickly acquire services related to pharmacy benefits managers, which are companies that manage prescription drug benefits for health plans. Specifically, the State will use an expedited process to hire vendors for technical assistance to evaluate potential pharmacy benefits managers, and for an online automated reverse auction service to compare pricing for these managers. A reverse auction is an online bidding process where qualified sellers compete by offering lower prices. The bill also mandates a real-time, electronic review of pharmacy claims using automated technology to compare invoices and audit services provided by the pharmacy benefits manager. The State will also procure a pharmacy benefits manager for the State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP). To facilitate this expedited procurement, the Division of Purchase and Property in the Department of the Treasury is empowered to waive or modify any conflicting laws or regulations, including modifying challenge periods, advertising on the division's website instead of formal advertisements, and shortening the State Comptroller's review period. Following the contract award, the division must publish a report within 60 days detailing the reverse auction results, cost savings, any deviations from standard procedures, and other information to ensure accountability. This bill takes effect immediately and will expire once the next pharmacy benefits manager contract is awarded, building upon a previous law from 2016 that also aimed to secure savings through a similar process.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 02/05/2026)
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/A4005 |
| BillText | https://pub.njleg.gov/Bills/2026/A4500/4005_I1.HTM |
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