The Assembly approved in mid-June legislation prohibiting prescription plans from charging copays in excess of the cash price of medications.
Assemblyman Ron Dancer sponsors the bill (S2690/A3993/A2214) to reduce the price con- sumers pay for their prescription drugs. It passed the Senate in February and moves to Gov. Phil Murphy’s desk for review.
Pharmacy benefit managers, middlemen controlling prescription drug plans for health insurers, “claw back” profits by setting copays that are higher than the cost of some commonly prescribed medicine. The schemes, uncovered in an NBC report, target generic medications frequently used to treat diabetes, hypertension, cholesterol, depression and anxiety.
“We’re doing away with the games and making the process fair and transparent,” said Dancer (R-Ocean). “Patients who need prescriptions for their health should not be subjected to prof- it-motivated deception.”
Dancer’s measure also bans gag clauses in insurance contracts preventing pharmacies from informing customers their prescriptions would cost less if they paid cash. The bill specifies that pharmacies are permitted to disclose lower cost options to patients.
“The deck is stacked against prescription users who have no idea this is going on,” said Dancer. “The gag clause prohibits the pharmacists from informing their customers of this scheme. That’s not acceptable. Nobody should pay more for required drugs because they are insured.”
Under Dancer’s bill, New Jersey would become the seventh state in three years to ban gag clauses and the 12th state to outlaw copay claw backs.