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NJ A4657
Bill
Status
Introduced
3/10/2026
Primary Sponsor
Luanne Peterpaul
Click for details
AI Summary
- Pharmacy benefits managers (PBMs) must submit detailed reports to health plan sponsors and the department at least every six months, covering drug claims, pricing, rebates, and compensation data by National Drug Code
- Reports must disclose the difference between what plan sponsors pay PBMs and what PBMs pay pharmacies for each drug, along with net prices after rebates from manufacturers, distributors, and other entities
- PBMs must report therapeutic class data including gross and net spending, rebates received, formulary tier rationales for drugs exceeding $10,000 in spending, and out-of-pocket costs to beneficiaries
- Plan sponsors may request annual audits of PBMs, with unrestricted auditor selection and PBM obligation to provide all records within six months and respond to additional requests within 30 days
- Takes effect 12 months after enactment and applies to contracts entered into on or after that date
Legislative Description
Requires pharmacy benefits managers to make certain disclosures to health benefits plan sponsors.
Financial Institutions and Insurance
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee
3/10/2026
Committee Referrals
Financial Institutions and Insurance3/10/2026
Full Bill Text
No bill text available