This Senate Resolution (SR 60) urges health insurance and prescription drug providers to include a simple "press zero" option on their automated phone systems, allowing callers to directly reach a human operator or leave a message during business hours. It specifically targets the frustration many experience - especially seniors and people with hearing impairments - when automated systems make it difficult to speak with a person. The resolution does not create new law but recommends this uniform method for contacting a human, and it directs copies to state agencies like the Banking Commissioner and Pharmacy Board. It directly affects consumers calling these providers and the providers themselves, who would need to adjust their phone systems.
This New Jersey bill requires pharmacy benefits managers (PBMs) to disclose pricing methodologies in contracts, including whether they use different pricing lists for retail versus mail-order drugs, and to provide a toll-free line for consumers to speak with a New Jersey-licensed pharmacist about drug pricing issues within 24 hours. It establishes a Prescription Drug Review Commission to identify critical prescription drugs (based on factors like cost to public health programs and treatment effectiveness) and monitor their pricing. These measures aim to increase transparency in drug pricing and reduce costs for essential medications, directly affecting PBMs and the state's Division of Consumer Affairs.
This bill prevents New Jersey's State Health Benefits Program (SHBP), School Employees' Health Benefits Program (SEHBP), and Medicaid from denying coverage for maintenance medications treating chronic conditions when a person's health plan or pharmacy provider changes. It requires coverage continuity if a patient was taking the medication before the plan change and the new plan covers that specific drug class. The law applies to state employees, school staff, and Medicaid recipients who rely on ongoing medication for conditions like diabetes or hypertension. It ensures these individuals won't lose access to essential medications due solely to administrative shifts in their health coverage plans.
This bill allows New Jersey to import prescription drugs from specific foreign countries (like Canada and other nations with equivalent drug safety standards) to lower costs for residents. It requires the Health Commissioner to establish a program within 120 days that designates entities to handle imports, ensures drugs meet FDA safety standards, and focuses on generating significant savings. The program must create price transparency for consumers, develop registration systems for pharmacies and health plans, and set up support resources like a hotline. Directly affected parties include New Jersey consumers, pharmacies, health benefits plans, and healthcare providers participating in the importation program. The bill does not change drug safety requirements but aims to leverage federal approval for cost-saving imports.
This bill regulates pharmacy benefits managers (PBMs) and insurance carriers to increase transparency and fairness in prescription drug coverage. It requires carriers and PBMs to establish pharmacy and therapeutics committees with strict conflict-of-interest rules, prohibits commission-based PBM compensation (mandating flat fees instead), and mandates detailed reporting of PBM fees for insurance filings. The law directly affects insurers, PBMs, and pharmacies by changing how drug formularies (approved drug lists) are managed and how PBM costs are calculated and disclosed. Key provisions include banning preferential formulary placement for higher-cost drugs over lower-cost generics/biosimilars and requiring actuarial documentation for PBM compensation. The bill aims to reduce patient cost-sharing and ensure PBM compensation aligns with administrative costs.
This bill prohibits pharmacy benefits managers (PBMs) from requiring individuals covered by health insurance plans to use mail-order pharmacies or automatically enrolling them in such programs without consent. It directly affects people covered under private health insurers, prescription benefit plans, or New Jersey's State Health Benefits Program and School Employees' Health Benefits Program. The key provision requires PBMs to offer a choice between mail and non-mail pharmacies, with written consent required before using a mail service option. The law takes effect January 1, 2027, ensuring covered persons can select their preferred pharmacy type without forced enrollment.
This bill requires New Jersey hospitals to report prescription drug pricing data to the Division of Consumer Affairs. It mandates hospitals (defined as general acute care hospitals licensed under state law) to submit accurate data on drug costs, including wholesale acquisition cost, under penalty of perjury. Non-compliance could result in civil penalties starting at $10,000 for the first day of violation and increasing up to $100,000 per day. The law also authorizes audits and corrective action plans for reporting deficiencies. This directly affects hospitals and other entities required to report drug pricing data under the amended statute.
This bill requires New Jersey's State Health Benefits Program (SHBP), School Employees Health Benefits Program (SEHBP), Medicaid, and NJ FamilyCare to cover FDA-approved anti-obesity medications for eligible individuals. It mandates coverage when a patient has a diagnosed obesity or related condition, receives a prescription from a licensed provider (physician, PA, or nurse), and obtains the medication through an approved pharmacy. Medicaid and NJ FamilyCare coverage depends on securing federal approval for necessary program waivers. The law applies to all four programs for members meeting these medical criteria, aiming to expand access to weight management treatment.
This bill (A 3412) provides lifetime health insurance coverage for live kidney donors in New Jersey. It requires the state to pay all premiums for a gold-level health plan through the New Jersey Individual Health Coverage Program, covering the donor for life with prescription drug coverage. The coverage is funded entirely by the newly established "Kidney Donor Insurance Fund" in the Department of Banking and Insurance, eliminating any cost to the donor or their employer. The bill applies to all live kidney donations occurring on or after its effective date.
S 3676 permits pharmacists in New Jersey to administer specific long-acting injectable drugs for psychiatric conditions, which are FDA-approved medications designed to treat symptoms with a single dose lasting up to 24 weeks. Pharmacists must meet certification requirements set by the New Jersey State Board of Pharmacy and the State Board of Medical Examiners, and administration requires a prescription from an authorized prescriber. The bill defines "long-acting injectable drugs" as those treating psychiatric disorders, excluding vaccines or non-psychiatric medications. This change expands pharmacists' scope of practice to include these specific drugs under regulated conditions, without altering existing prescription requirements.
