TRENTON, N.J. – The Assembly votes Monday on legislation to restrict insurers from levying copayments higher than the cash price of medications.
Assemblyman Ron Dancer sponsors the bill (S2690/A3993) seeking to reduce the price consumers pay for their prescription drugs.
Pharmacy benefit managers, middlemen controlling prescription drug plans for health insurers, “claw back” profits by setting copays that are higher than the cash price of some commonly prescribed medicine. The schemes, uncovered by a recent NBC report, target drugs frequently prescribed 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 profit-motivated deception.”
Dancer’s measure also does away with gag clauses in many insurance contracts preventing pharmacies from informing customers their prescription would cost less is 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.”
Dancer’s bill would make New Jersey the seventh state in three years to ban gag clauses and the twelfth state to outlaw copay clawbacks.
The bill passed the Senate in February. With Assembly approval, it will go to Gov. Phil Murphy’s desk for review.