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A5012 • 2026

Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.

Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Peterpaul, Luanne M., Esq.
Last action
2026-05-07
Official status
Introduced, Referred to Assembly Financial Institutions and Insurance Committee
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.

Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.

What This Bill Does

  • Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.
  • Topic: Financial Institutions and Insurance Fiscal note: This bill has not been certified by OLS for a fiscal note.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-05-07 New Jersey Legislature

    Introduced, Referred to Assembly Financial Institutions and Insurance Committee

Official Summary Text

Requires certain standards be established for contracts between pharmacy benefits managers and health benefits plans.
Topic:
Financial Institutions and Insurance
Fiscal note:
This bill has not been certified by OLS for a fiscal note.

Current Bill Text

Read the full stored bill text 
A5012

ASSEMBLY, No. 5012

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

���� Requires certain standards be established for
contracts between pharmacy benefits managers and health benefits plans.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act
concerning contract terms for pharmacy benefits
managers and supplementing P.L.2015, c.179
(C.17B:27F-1 et seq.).

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

���� 1.��� a.� A health benefits
plan that provides coverage of prescription drugs or pharmacy services that is
administered or managed by a pharmacy benefits manager shall allow any pharmacy
that meets the standard contract terms and conditions under the benefits plan
to participate as a network pharmacy.

���� b.��� The terms and conditions
of the contract shall be reasonable and relevant as determined by the
Commissioner of Banking and Insurance.� To determine what is reasonable and
relevant, the commissioner shall review, among other items:

���� (1)�� current terms and
conditions in network pharmacy contracts; and

���� (2)�� reimbursement and
dispensing fees paid by the health benefits plans and if the payments are
sufficient to cover ingredient and operational costs.

���� 2.��� The Commissioner of
Banking and Insurance may adopt rules and regulations, in accordance with the
�Administrative Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), as are
necessary to effectuate the provisions of this act.

���� 3.��� This act shall take
effect on the first day of the thirteenth month next following the date of
enactment and shall apply to contracts between a health benefits plan and a
pharmacy benefits manager that are initiated or renewed on or after the date of
enactment.

STATEMENT

���� This bill requires a health
benefits plan that provides coverage of prescription drugs or pharmacy services
that is administered or managed by a pharmacy benefits manager to allow any
pharmacy that meets the standard contract terms and conditions under the
benefits plan to participate as a network pharmacy.� The terms and conditions
of the contract are to be reasonable and relevant as determined by the
Commissioner of Banking and Insurance.� To determine what is reasonable and
relevant, the commissioner is to review, among other items: 1) current terms
and conditions in network pharmacy contracts; and 2) reimbursement and
dispensing fees paid by the health benefits plans and if the payments are
sufficient to cover ingredient and operational costs.