2023 New Jersey Revised Statutes
Title 17B - Insurance
Section 17B:27F-3.2 - Compensation remitted, pharmaceutical manufacturer, developer, labeler, carrier, pharmacy benefits manager under contract; report.
17B:27F-3.2 Compensation remitted, pharmaceutical manufacturer, developer, labeler, carrier, pharmacy benefits manager under contract; report.
6. a. Compensation remitted by or on behalf of a pharmaceutical manufacturer, developer or labeler, directly or indirectly, to a carrier or to a pharmacy benefits manager under contract with a carrier related to prescription drug benefits shall be:
(1) remitted directly to the covered person at the point of sale to reduce the out-of-pocket cost to the covered person associated with a particular prescription drug; or
(2) remitted to, and retained by, the carrier. Compensation remitted to the carrier shall be applied by the carrier in its plan design and in future plan years to offset the premium for covered persons.
b. Beginning on March 1 next following the effective date of P.L.2023, c.107 (C.17B:27F-1.1 et al.), and annually thereafter, a carrier shall file with the department a report explaining how the carrier has complied with the provisions of this section. The report shall be written in a manner and form determined by the department.
c. Nothing in this section shall preclude a carrier or pharmacy benefits manager under contract with a carrier from implementing a program designed to lower a covered person's out-of-pocket cost or decreasing a covered person's out-of-pocket cost by an amount greater than that required under subsection a. of this section.
d. As used in this section, "compensation" means any direct or indirect financial benefit, including, but not limited to, rebates, discounts, credits, fees, grants, chargebacks or other payments or benefits of any kind, that is attributed to, directly or indirectly, the utilization of a health benefits plan or enrollment in a health benefits plan, regardless of how the benefits are otherwise characterized by a pharmacy benefits manager and relevant third parties.
L.2023, c.107, s.6.
