Bill > S4208

Introduced Session

This bill prohibits pharmacy benefit managers from using spread pricing as a form of compensation in contracts for pharmacy benefits management services with carriers, health benefits plans, and pharmacies. Spread pricing is when a pharmacy benefits manager charges a health benefits plan or carrier a contracted price for a prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacy benefit manager directly or indirectly pays the pharmacy. The bill bans the use of spread pricing by a pharmacy benefit manager, and it restricts a pharmacy benefit manager from entering into a contract to provide pharmacy benefits management services unless the contract provides that the pharmacy benefits manager remits 100 percent of rebates, fees, alternative discounts, and other remuneration received from any applicable entity that are related to the utilization of drugs or drug spending under the health benefits plan to the carrier, health benefits plan, or the purchaser. Additionally, the bill provides that a pharmacy benefit manager is required to submit to the Department of Banking and Insurance financial statements prepared as of the close of its fiscal year within 120 days after the close of the fiscal year, and that the department will conduct an audit of those statements. Further, the bill provides that the commissioner may require the submission of these reports on a monthly or other periodic basis. Finally, on an annual basis starting one year following the date of enactment, the bill requires the department to submit a report to the Governor and the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), with all personal identifying information removed, on the compensation and pricing, and financial statements of pharmacy benefit managers, and how, if at all, that compensation and pricing impacts the cost of health benefits plans to covered persons. The bill requires the report to be available to the public on the department's website.

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Raj Mukherji (D)*, 

Introduced in the Senate, Referred to Senate Commerce Committee (on 05/11/2026)

Official Document