Bill Text: NJ A1119 | 2010-2011 | Regular Session | Introduced
Bill Title: Prohibits penalizing pharmacy for dispensing forged or fraudulent prescription approved by certain State prescription drug benefit programs.
Spectrum: Strong Partisan Bill (Democrat 12-1)
Status: (Failed) 2010-02-08 - Withdrawn from Consideration [A1119 Detail]
Download: New_Jersey-2010-A1119-Introduced.html
STATE OF NEW JERSEY
214th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2010 SESSION
Sponsored by:
Assemblywoman ELEASE EVANS
District 35 (Bergen and Passaic)
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington and Camden)
Co-Sponsored by:
Assemblyman Prieto, Assemblywoman Tucker, Assemblyman Chiappone, Assemblywomen Quijano, Rodriguez, Wagner, Assemblymen Green, Giblin, Schaer, Conners and Assemblywoman Handlin
SYNOPSIS
Prohibits penalizing pharmacy for dispensing forged or fraudulent prescription approved by certain State prescription drug benefit programs.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning forged and fraudulent prescriptions and supplementing P.L.1968, c.413 (C.30:4D-1 et seq.), P.L.1975, c.194 (C.30:4D-20 et seq.), and P.L.2001, c.96 (C.30:4D-43 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. A pharmacy shall receive full payment and shall not be penalized for dispensing a forged or fraudulent prescription that has been approved by the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), unless the pharmacist or his employee or agent has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud.
b. As used in this section, "has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud" means that a person:
(1) knowingly and willfully made or caused to be made any false statement or representation of a material fact in any document or electronic transmission necessary to receive payment by the program for the prescription;
(2) knowingly and willfully made or caused to be made any false statement, written or oral, of a material fact for use in determining the right to payment by the program for the prescription; or
(3) concealed or failed to disclose a fact or the occurrence of an event that affects the right to payment by the program for the prescription.
c. The provisions of this section shall not be construed as relieving a pharmacist of his obligation to comply with any requirements provided under any State or federal statute or regulation for the pharmacist:
(1) to seek verification of a prescription from an authorized prescriber or the latter's authorized agent before filling the prescription whenever the pharmacist has reason to question the authenticity, accuracy, or appropriateness of the prescription; and
(2) to not fill the prescription when the authenticity, accuracy, or appropriateness of the prescription is in question and no such verification has been provided.
d. The State Medicaid program shall make every reasonable effort to identify an individual who has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud and collect from the individual the amount paid by the program for the dispensed prescription, in addition to any other penalties that may apply. If the forgery or fraud involves the misuse or theft of a Medicaid eligibility identification card, the card shall be recalled.
2. a. A pharmacy shall receive full payment and shall not be penalized for dispensing a forged or fraudulent prescription that has been approved by the "Pharmaceutical Assistance to the Aged and Disabled" program established pursuant to P.L.1975, c.194 (C.30:4D-20 et seq.), unless the pharmacist or his employee or agent has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud.
b. As used in this section, "has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud" means that a person:
(1) knowingly and willfully made or caused to be made any false statement or representation of a material fact in any document or electronic transmission necessary to receive payment by the program for the prescription;
(2) knowingly and willfully made or caused to be made any false statement, written or oral, of a material fact for use in determining the right to payment by the program for the prescription; or
(3) concealed or failed to disclose a fact or the occurrence of an event that affects the right to payment by the program for the prescription.
c. The provisions of this section shall not be construed as relieving a pharmacist of his obligation to comply with any requirements provided under any State or federal statute or regulation for the pharmacist:
(1) to seek verification of a prescription from an authorized prescriber or the latter's authorized agent before filling the prescription whenever the pharmacist has reason to question the authenticity, accuracy, or appropriateness of the prescription; and
(2) to not fill the prescription when the authenticity, accuracy, or appropriateness of the prescription is in question and no such verification has been provided.
d. The program shall make every reasonable effort to identify an individual who has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud and collect from the individual the amount paid by the program for the dispensed prescription, in addition to any other penalties that may apply. If the forgery or fraud involves the misuse or theft of a "Pharmaceutical Assistance to the Aged and Disabled" program eligibility identification card, the card shall be recalled.
3. a. A pharmacy shall receive full payment and shall not be penalized for dispensing a forged or fraudulent prescription that has been approved by the "Senior Gold Prescription Discount Program" established pursuant to P.L.2001, c.96 (C.30:4D-43 et seq.), unless the pharmacist or his employee or agent has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud.
b. As used in this section, "has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud" means that a person:
(1) knowingly and willfully made or caused to be made any false statement or representation of a material fact in any document or electronic transmission necessary to receive payment by the program for the prescription;
(2) knowingly and willfully made or caused to be made any false statement, written or oral, of a material fact for use in determining the right to payment by the program for the prescription; or
(3) concealed or failed to disclose a fact or the occurrence of an event that affects the right to payment by the program for the prescription.
c. The provisions of this section shall not be construed as relieving a pharmacist of his obligation to comply with any requirements provided under any State or federal statute or regulation for the pharmacist:
(1) to seek verification of a prescription from an authorized prescriber or the latter's authorized agent before filling the prescription whenever the pharmacist has reason to question the authenticity, accuracy, or appropriateness of the prescription; and
(2) to not fill the prescription when the authenticity, accuracy, or appropriateness of the prescription is in question and no such verification has been provided.
d. The program shall make every reasonable effort to identify an individual who has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud and collect from the individual the amount paid by the program for the dispensed prescription, in addition to any other penalties that may apply. If the forgery or fraud involves the misuse or theft of a Senior Gold eligibility identification card, the card shall be recalled.
4. This act shall take effect immediately.
STATEMENT
The purpose of this bill is to ensure that an individual who commits prescription drug forgery or fraud, rather than the pharmacist who unwittingly dispenses a forged or fraudulent prescription, under certain State-funded prescription drug benefit programs is penalized for the forgery or fraud.
The bill provides specifically as follows:
· A pharmacy is to receive full payment and not be penalized for dispensing a forged or fraudulent prescription that has been approved by the State Medicaid program, the "Pharmaceutical Assistance to the Aged and Disabled" (PAAD) program, or the "Senior Gold Prescription Discount Program" (Senior Gold), unless the pharmacist or his employee or agent has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud.
· The bill defines the phrase, "has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud," to mean that a person:
-- knowingly and willfully made or caused to be made any false statement or representation of a material fact in any document or electronic transmission necessary to receive payment by the respective program for the prescription;
-- knowingly and willfully made or caused to be made any false statement, written or oral, of a material fact for use in determining the right to payment by the respective program for the prescription; or
-- concealed or failed to disclose a fact or the occurrence of an event that affects the right to payment by the respective program for the prescription.
· The provisions of the bill are not to be construed as relieving a pharmacist of his obligation to comply with any requirements provided under any State or federal statute or regulation for the pharmacist:
-- to seek verification of a prescription from an authorized prescriber or the latter's authorized agent before filling the prescription whenever the pharmacist has reason to question the authenticity, accuracy, or appropriateness of the prescription; and
-- to not fill the prescription when the authenticity, accuracy, or appropriateness of the prescription is in question and no such verification has been provided.
· The Medicaid, PAAD, and Senior Gold programs must make every reasonable effort to identify an individual who has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud under the respective program and collect from the individual the amount paid by the program for the dispensed prescription, in addition to any other penalties that may apply.
If the forgery or fraud involves the misuse or theft of a Medicaid, PAAD, or Senior Gold eligibility identification card, the card is to be recalled.
