(TRENTON) – An Assembly panel on Monday approved legislation Troy Singleton sponsored to require pharmacy benefits managers to disclose certain information to benefit plan purchasers and to establish toll-free telephone number for certain inquiries.
The bill (A-4338), also known as the “Prescription Drug Transparency Act,” would supplement current law by requiring pharmacy benefits managers (PBMs) to disclose certain information about prescription drug pricing and generic substitutions to benefit plan purchasers. The bill would also require PBMs to establish a toll-free telephone number through which consumers and pharmacists can quickly obtain information regarding coverage, pricing and prescription drug safety.
“This proposal would help health care consumers tremendously by increasing transparency in prescription drug pricing by allowing consumers to more easily access vital information regarding their prescriptions,” said Singleton (D-Burlington) “Additionally, businesses should know their prescription costs, what medicines their employee health benefits plans will cover and understand the effects of the medicines they’re prescribed on the health and welfare of their employees and their financial bottom line.”
If a purchaser of pharmacy benefits management services requests at the time of contracting, this bill would require PBMs to disclose, in the contract entered into between the purchaser and the PBM, the basis of the methodology and sources utilized to determine multiple source generic drug pricing. That pricing information shall be updated whenever a change occurs and be provided to the purchaser upon request.
If a PBM uses a multiple source generic list for drugs dispensed at retail, but not for drugs dispensed by mail, this must be disclosed in the contract as well, or within 21 business days from the implementation of the practice. In addition, the bill would require PBMs to disclose to purchasers whether the multiple source generic pricing list used to bill the purchaser is the same as the list used to reimburse pharmacies. If the lists are not the same, the difference between the amount paid to the pharmacy and the amount charged to the purchaser shall be disclosed.
Under the bill, PBMs are required to provide a toll-free telephone number for consumers and contracted pharmacies to speak with a pharmacy benefits manager concerning benefits coverage and drug pricing and a New Jersey-licensed pharmacist to resolve issues related to prescription drug safety. Concerns must be resolved within 24 hours of receiving the inquiry.
The bill would take effect on the 90th day next following enactment and shall apply to all contracts or agreements for pharmacy benefits management services that are executed or renewed on or after the effective date.
The Assembly Financial Institutions and Insurance Committee released the bill in an afternoon meeting. It now goes to the Assembly Speaker for further consideration.