Sponsored by:
Assemblywoman CAROL A. MURPHY
District 7 (Burlington)
SYNOPSIS
Requires Medicaid preferred drug lists to provide for coverage of buprenorphine for treatment of chronic pain.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid preferred drug lists and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Notwithstanding any law, rule, or regulation to the contrary, a preferred drug list, drug formulary, or other authorized list of covered drugs implemented by the Division of Medical Assistance and Human Services within the Department of Human Services for the provision of pharmacy services under Medicaid or by a managed care organization contracted with the division to provide Medicaid pharmacy services shall provide for the coverage of buprenorphine for the treatment of chronic pain, without the imposition of any step therapy requirement, provided that the buprenorphine is prescribed by a licensed medical practitioner who is authorized to prescribe that drug pursuant to State and federal law.
As used in this section:
"Chronic pain" means pain that persists or recurs for more than three months.
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Step therapy requirement" means a requirement within a preferred drug list, drug formulary, or other authorized list of covered drugs for a beneficiary to use one drug before benefits for the use of another drug can be authorized.
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act.
4. This act shall take
effect immediately and apply to any contract between
a managed care organization and the Division of Medical Assistance and
Health Services to provide Medicaid pharmacy services which has been entered into or renewed after the effective date of this
act.
STATEMENT
This bill requires preferred drug lists under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), to provide for coverage of buprenorphine for treatment of chronic pain. Specifically, under the bill, a preferred drug list, drug formulary, or other authorized list of covered drugs implemented by the Division of Medical Assistance and Human Services within the Department of Human Services for the provision of pharmacy services under the Medicaid program or by a managed care organization contracted with the division to provide pharmacy services under the Medicaid program shall provide for the coverage of buprenorphine for the treatment of chronic pain, without the imposition of any step therapy requirement, provided that the buprenorphine is prescribed by a licensed medical practitioner who is authorized to prescribe that drug pursuant to State and federal law. The bill defines "chronic pain" as pain that persists or recurs for more than three months, and "step therapy requirement" as a requirement within a preferred drug list, drug formulary, or other authorized list of covered drugs for a beneficiary to use one drug before benefits for the use of another drug can be authorized.