New Jersey A 5020: Prohibits water utility from taking certain actions if utility fails to participate in Low Income Household Water Assistance Program.

Bill Text

A5020 

ASSEMBLY, No. 5020 

STATE OF NEW JERSEY

222nd LEGISLATURE

� 

INTRODUCED MAY 7, 2026

Sponsored by:

Assemblywoman� LUANNE M. PETERPAUL

District 11 (Monmouth)

Co-Sponsored by:

Assemblyman Kearney

SYNOPSIS

���� Prohibits pharmacy benefit manager from using spread 
pricing as model of prescription drug pricing; requires transparency in 
provision of pharmacy benefits management services. 

CURRENT VERSION OF TEXT 

���� As introduced.

�� 

An Act concerning pharmacy benefit managers and amending 
P.L.2023, c.107.

���� Be It 
Enacted by the Senate and General Assembly of 
the State of New Jersey:

���� 1.��� Section 3 of P.L.2023, 
c.107 (C.17B:27F-3.1) is amended to read as follows:

���� 3. a. A carrier shall: 

���� (1) monitor all activities 
carried out on behalf of the carrier by a pharmacy benefits manager if the 
carrier contracts with a pharmacy benefits manager and is related to a 
carrier's prescription drug benefits; and 

���� (2) ensure that all 
requirements of this section are met.

���� b.��� A carrier that contracts 
with a pharmacy benefits manager to perform any activities related to the 
carrier's prescription drug benefits shall ensure that, under the contract, the 
pharmacy benefits manager acts as the carrier's agent in good faith and fair 
dealing in the performance of all of its contractual duties.� All funds 
received by the pharmacy benefits manager in relation to providing pharmacy 
benefits management services shall be used or distributed only pursuant to the 
pharmacy benefits manager's contract with the health benefits plan or carrier 
or applicable law; including any administrative fee or payment to the pharmacy 
benefits manager expressly provided for in the contract to compensate the 
pharmacy benefits manager for its services.� Any funds received by the pharmacy 
benefits manager through spread pricing shall be subject to this subsection.

���� c. (1) A pharmacy benefits 
manager interacting with a covered person shall have the same duty to a covered 
person as the health benefits plan or carrier for whom it is performing 
pharmacy benefits management services.

���� (2) A pharmacy benefits 
manager shall have a duty of good faith and fair dealing with all parties, 
including but not limited to covered persons and pharmacies, with whom it 
interacts in the performance of pharmacy benefits management services.

���� d.��� A carrier or pharmacy 
benefits manager shall not require a covered person to make a payment at the 
point of sale for a covered prescription drug in an amount greater than the 
lesser of: 

���� (1) the applicable 
cost-sharing amount for the prescription drug; or

���� (2) the amount a covered 
person would pay for the prescription medication if the covered person 
purchased the prescription medication without using a health benefits plan.

���� e.���� A carrier shall provide 
a reasonably adequate retail pharmacy network for the provision of prescription 
drugs for its covered persons.

���� f.���� (1) Notwithstanding 
any provision to the contrary, a pharmacy benefits manager shall not utilize 
spread pricing in the provision of pharmacy benefits management services or enter 
into any contract or arrangement, or extension or renewal of a contract or 
arrangement, for pharmacy benefit management services with a carrier, 
purchaser, or pharmacy, unless the contract or arrangement specifies that the 
pharmacy benefits manager remits 100 percent of rebates, fees, alternative 
discounts, and other remuneration received from any applicable entity that are 
related to the utilization of drugs or drug spending under the health benefits 
plan to the carrier, health benefits plan, or the purchaser.

���� (2)�� Nothing in this 
subsection shall prevent a pharmacy benefits manager from charging a pharmacy 
benefit management fee or from entering into a contract for a passthrough 
pricing model for compensation for services provided.

���� (3)�� In a manner and form 
as prescribed by the commissioner, a pharmacy benefit manager shall submit to 
the department financial statements prepared as of the close of its fiscal year 
within 120 days after the close of the fiscal year. �These financial statements 
shall be accompanied by a report, certificate, or opinion of an independent 
certified public accountant or independent public accountant. �An audit shall 
be conducted in accordance with generally accepted auditing standards and the 
rules and regulations of the department.� Within 45 days after the close of each 
quarter of its fiscal year, a pharmacy benefit manager shall submit its 
quarterly unaudited financial statement, prepared in accordance with generally 
accepted accounting principles and consisting of at least a balance sheet, 
statement of income, statement of cash flows, statement of changes in equity, 
and notes to financial statements as of the date and for the period specified 
by the commissioner. �The commissioner may require the s