New Jersey S4205 mandates that pharmacy benefits manager compensation be based on a bona fide service fee.
New Jersey S4205 amends existing law to require that compensation for pharmacy benefits managers be based on a bona fide service fee. This fee must reflect the fair market value for a service actually performed, as determined by the Commissioner of Banking and Insurance. The compensation cannot be based on drug prices, discounts, rebates, formulary placement decisions, or other prohibited amounts. The bill also mandates that any rate filings by carriers include a memorandum from a qualified actuary detailing the calculation of the pharmacy benefits manager compensation.
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