Requires prescription drug services covered under Medicaid program to be provided via fee-for-service delivery system.
S 2067 requires New Jersey's Medicaid program to provide prescription drug services through a direct fee-for-service payment system instead of the current managed care model. It mandates that pharmacies dispensing covered drugs (including mail-order, specialty, and clotting factors) receive reimbursement based on the lowest of several cost calculations - such as national drug averages or state-set limits - plus a fixed $10.92 dispensing fee. This directly affects Medicaid beneficiaries (who receive covered drugs) and pharmacies (which will be paid directly under new rules). The bill aims to simplify payment structures and aligns with similar policies in states like West Virginia and New York that reported cost savings through similar fee-for-service transitions.
Bill status
in committee
1 of 4 stages cleared
Introduction
Jan 2024
Committee Review
Floor Vote
Governor
Introduced Jan 9, 2024
Last action Jan 9, 2024
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Full legislative history
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1
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0
Committee
0
Jan 9, 2024
Introduced
Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee
upper
2 primary · 0 co-sponsors
Sponsors
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