Legislation Requires Pharmacy Benefits Managers to Obtain Certificate from DOBI to Operate in NJ
(TRENTON) – Legislation sponsored by Assembly Democrats Craig Coughlin, Raj Mukherji, Daniel Benson, Joann Downey and Eric Houghtaling to ensure pharmacy benefits managers are vetted by New Jersey Department of Banking and Insurance before operating in the state was approved Monday by the Assembly, giving it final legislative approval.
The bill now goes to the governor.
The bill (A-4676), entitled the “Prescription Drug Patient Protection Act,” requires pharmacy benefits managers to obtain, in accordance with the bill’s provisions, a certificate of authority form the Commissioner of Banking and Insurance in order to operate in this state.
A pharmacy benefit manager (PBM) is a third-party administrator of prescription-drug programs for end payers, such as private insurers, and Medicare Part D plans. The sponsors of the bill note a number of complaints about PBMS driving up costs and the purpose of this bill is to provide transparency, accountability and potentially lower costs to consumers.
“The state must ensure patient protection when dealing with third-party pharmacy benefit managers,” said Coughlin (D- Middlesex). “With the rise in the cost of healthcare and the price of prescriptions, we must do all that we can to ensure residents are not being taken advantage of by anyone raising the prices of the prescriptions they need unnecessarily.”
“New Jersey law protects access to prescription drugs by seniors and other patients with its any willing provider laws, but recently history reveals that third-party PBMs on behalf of insurance companies have sought to circumvent those consumer protections,” said Mukherji (D-Hudson). “This legislation ensures that any pharmacy benefits manager operating in our state is approved to do so and understands the regulations applicable to their dealings.”
“Requiring PBMs to apply, register and be reviewed by the state before operating ensures the state’s ability to keep track of pharmacy benefit managers in the state and act on any complaints made about services,” said Benson (D- Mercer, Middlesex). “This pro-consumer legislation will help to protect the many residents who use third-party pharmacy benefits managers from unscrupulous dealings.”
“Prescriptions drug prices continue to escalate in the country,” said Downey (D-Monmouth). “Residents who need life-saving medications should not be subject to extra costs imposed as a result of having to work with a third-party pharmacy benefits manager. The state should also be aware of every PBM that operates in this state and how they deal with New Jersey patients.”
“The state must ensure that nothing impedes patient access to the medications required by their doctor,” said Houghtaling (D-Monmouth). “This legislation would provide increased transparency and accountability for all pharmacy benefit managers operating in this state. It is critical to patient protection in New Jersey.”