NJ S378

Pharmacy benefits managers (PBMs) would be required to have a fiduciary duty to the financial interests of covered persons, meaning they must prioritize patients' financial interests above those of the health insurance carriers they contract with.

PBMs must continue to act as the carrier's agent in good faith while also maintaining duties of good faith and fair dealing with covered persons and pharmacies.

Carriers and PBMs cannot require covered persons to pay more at the point of sale than either the applicable cost-sharing amount or the cash price without insurance, whichever is lower.

The law applies to State Health Benefits Plan, School Employees' Health Benefits Plan, State Medicaid, and self-insured ERISA plans.

The bill takes effect 180 days after enactment and applies to all contracts and policies delivered, issued, executed, or renewed after that date.