New Jersey Statutes 30:4D-7ee. Pharmacy benefits management services, information disclosure
Attorney's Note
Under the New Jersey Statutes, punishments for crimes depend on the classification. In the case of this section:| Class | Prison | Fine |
|---|---|---|
| crime of the fourth degree | up to 18 months | up to $10,000 |
Terms Used In New Jersey Statutes 30:4D-7ee
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Department: means the Department of Human Services. See New Jersey Statutes 30:1-1
- person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
- State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2
(1) all sources and amounts of income, payments, and financial benefits received by the pharmacy benefits manager in relation to the provision and administration of pharmacy benefits management services on behalf of the managed care organization, including, but not limited to, any pricing discounts, rebates of any kind, inflationary payments, credits, clawbacks, fees, grants, chargebacks, reimbursements, or other benefits;
(2) all ingredient costs and dispensing fees or similar payments made by the pharmacy benefits manager to any pharmacy in connection with the contract or other arrangement; and
(3) the pharmacy benefits manager’s payment model for administrative fees.
b. Information disclosed by a pharmacy benefits manager to the division pursuant to subsection a. of this section shall be confidential and not be subject to public disclosure under P.L.1963, c.73 (C. 47:1A-1 et seq.), or P.L.2001, c.404 (C. 47:1A-5 et al.). In addition to any other penalty provided by law, a person who is authorized to access information submitted by a pharmacy benefits manager to the division who knowingly discloses such information to any person or entity who is not authorized to access the information shall be guilty of a crime of the fourth degree and shall be subject to a civil penalty in an amount not to exceed $10,000. A civil penalty imposed under this subsection shall be collected by the director pursuant to the “Penalty Enforcement Law of 1999,” P.L.1999, c.274 (C. 2A:58-10 et seq.).
c. As used in this section:
“Pharmacy benefits manager” means a corporation, business, or other entity, or unit within a corporation, business, or other entity, that administers prescription drug benefits on behalf of a managed care organization.
“Pharmacy benefits management services” mean the provision of any of the following services on behalf of a managed care organization: the procurement of prescription drugs at a negotiated rate for dispensation within this State; the processing of prescription drug claims; or the administration of payments related to prescription drug claims.
L.2021, c.257.