The New Jersey Pharmacy Fair Reimbursement and Anti-Steering Act aims to improve transparency and fairness within the pharmacy benefits management (PBM) industry by implementing several key provisions. The bill requires PBMs to report detailed data to the state division, including wholesale acquisition costs and financial metrics related to drug pricing and rebates. It also mandates the disclosure of prior authorization metrics and spread pricing revenue. Notably, the legislation prohibits spread pricing in contracts with state health programs and requires PBMs to reimburse pharmacies based on the National Average Drug Acquisition Cost (NADAC), ensuring fair compensation practices.

Additionally, the act introduces anti-steering measures to prevent PBMs from directing consumers to specific pharmacies in which they have a financial interest. It establishes geographic access standards for pharmacies and includes protections during audits, limiting their frequency and prohibiting recoupments for minor clerical errors. The bill also mandates the creation of a price comparison tool for consumers and the establishment of a Compliance and Enforcement Unit to oversee adherence to the new regulations. Overall, the legislation seeks to protect consumers and pharmacies by promoting fair reimbursement practices and enhancing access to affordable medications.

Statutes affected:
Introduced: 45:14-82.4, 17B:27F-1