New Jersey legislature takes on PBMs

NCPA February 21, 2019

Each week, we highlight a piece of state legislation introduced this session or a state regulatory initiative that could move the needle on changing the pharmacy payment model.

New Jersey is tackling PBMs' opaque, retroactive reimbursement adjustments. The bill, A3717/S728, is moving through the legislature and would prohibit retroactive pharmacy fees, bringing increased transparency and clarity to point-of-sale reimbursements. It would also expand the state's existing MAC transparency laws to include all reimbursement formulas, including generic effective rate, brand effective rate, and dispensing fee effective rate. Championed by the New Jersey Pharmacists Association, Garden State Pharmacy Owners, and the Independent Pharmacy Alliance, the measure will keep PBMs from hiding true prescription drug costs from patients, payers, and pharmacies.