NJ S464

Pharmacy benefit managers (PBMs) must pay or reimburse pharmacy claims within 14 calendar days of receipt, or provide written/electronic notice that the claim is contested or denied within that timeframe

PBMs are required to submit records, contracts, documents, and data to the Department of Banking and Insurance annually for audit purposes, rather than only upon request as under current law

Contracts between PBMs and pharmacies must include drug pricing sources, brand/generic effective rates, dispensing fees, and maximum allowable cost information, with pricing updates required every seven calendar days

The bill takes effect on the first day of the fourth month after enactment, with the 14-day claim payment requirement applying to claims received on or after that date

Civil penalties up to $500 may be imposed on authorized persons who willfully disclose confidential PBM information to unauthorized parties