Bill Text: NJ A3159 | 2022-2023 | Regular Session | Introduced
Bill Title: Requires hiring of vendor to manage Medicaid Multi-State Pooling Supplemental Rebate Arrangement program and associated uniform Preferred Drug List.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced - Dead) 2022-03-14 - Reported and Referred to Assembly Health Committee [A3159 Detail]
Download: New_Jersey-2022-A3159-Introduced.html
Sponsored by:
Assemblyman JOHN F. MCKEON
District 27 (Essex and Morris)
SYNOPSIS
Requires hiring of vendor to manage Medicaid Multi-State Pooling Supplemental Rebate Arrangement program and associated uniform Preferred Drug List.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid and the cost of prescription drugs and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. As used in this section:
"Board" means the Drug Utilization Review Board established pursuant to section 2 of P.L.1998, c.41 (C.30:4D-17.17a) in connection with State pharmaceutical benefits programs.
"Department" means the Department of Human Services.
"Division" means the Division of Medical Assistance and Health Services in the Department of Human Services.
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
b. Notwithstanding the provisions of any other law to the contrary, the division shall establish and maintain a third-party contract with a single vendor for the vendor to manage the operations of a Multi-State Pooling Supplemental Rebate Arrangement program, and the associated uniform Preferred Drug List, under the Medicaid program, for the duration of such programs, which shall include the following services provided by the vendor:
(1) assistance to the department in evaluating the financial and clinical implications of uniform Preferred Drug List implementation on various drug classes;
(2) support to the board, and, as appropriate, to other State clinical committees in the form of clinical recommendations and other related services;
(3) education and training for patients, prescribers, and health insurance plans as determined by the department;
(4) data integration between fee-for-service systems and managed care systems;
(5) access to pooled Medicaid pharmaceutical manufacturer supplemental rebate agreements across drug classes;
(6) centralized negotiation, invoicing, reconciling, and rebate collection, including dispute resolution services on behalf of the State; and
(7) any other services as determined by the department.
c. The contract with the vendor shall be established in an expedited fashion, without the need for formal advertisement, and through the solicitation of proposals from vendors who provide professional services. The division shall consider price, prior experience, and other relevant factors in selecting a vendor.
d. Notwithstanding the provisions of any other law to the contrary, in order to effectuate the provisions of this section in an expedited manner, the following provisions shall be deemed modifications to law and to corresponding regulations for the purposes of this act only:
(1) the timeframes for challenging the specifications shall be modified as determined by the division;
(2) in lieu of advertising in accordance with sections 2, 3, and 4 of P.L.1954, c.48 (C.52:34-7, C.52:34-8, and C.52:34-9), the division shall advertise the request for proposals for the above services and any addenda thereto on the division's website;
(3) the timeframes for submission under section 4 of P.L.2012, c.25 (C.52:32-58) and section 1 of P.L.1977, c.33 (C.52:25-24.2) shall be extended to prior to the issuance of a Notice of Intent to Award; and
(4) the term "bids" in subparagraph (f) of subsection a. of section 7 of P.L.1954, c.48 (C.52:34-12) shall not include pricing which will be revealed to all responsive bidders during the negotiation process.
2. The Commissioner of Human Services may adopt rules and regulations, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), and may waive any laws or regulations, as necessary to effectuate the provisions of this act.
3. This act shall take effect immediately.
STATEMENT
This bill requires the hiring of a vendor to manage the Medicaid Multi-State Pooling Supplemental Rebate Arrangement program and associated uniform Preferred Drug List for the NJ FamilyCare program.
Under the bill, the Division of Medical Assistance and Health Services in the Department of Human Services (division) is to establish and maintain a third-party contract with a single vendor for the vendor to manage the operations of a Medicaid Multi-State Pooling Supplemental Rebate Arrangement and associated uniform Preferred Drug List for the NJ FamilyCare program, for the duration of such programs, which is to include the following services provided by the vendor: (1) assistance to the Department of Human Services (department) in evaluating the financial and clinical implications of uniform Preferred Drug List implementation on various drug classes; (2) support to the New Jersey Drug Utilization Review Board, and, as appropriate, to other State clinical committees in the form of clinical recommendations and other related services; (3) education and training for patients, prescribers, and health insurance plans as determined by the department; (4) data integration between fee-for-service systems and managed care systems; (5) access to pooled Medicaid pharmaceutical manufacturer supplemental rebate agreements across drug classes; (6) centralized negotiation, invoicing, reconciling, and rebate collection, including dispute resolution services on behalf of the State; and (7) any other services as determined by the department.
The bill provides that the contract with the vendor is to be established in an expedited fashion, without the need for formal advertisement, and through the solicitation of proposals from vendors who provide professional services. The division is to consider price, prior experience, and other relevant factors in selecting a vendor.
In order to effectuate the bill's provisions in an expedited manner, the following provisions are to be deemed modifications to law and corresponding regulations for the purposes of this bill only: (1) the timeframes for challenging the specifications are to be modified as determined by the division; (2) in lieu of advertising in accordance with sections 2, 3, and 4 of P.L.1954, c.48 (C.52:34-7, C.52:34-8, and C.52:34-9), the division is to advertise the request for proposals for the above services and any addenda thereto on the division's website; (3) the timeframes for submission under section 4 of P.L.2012, c.25 (C.52:32-58) and section 1 of P.L.1977, c.33 (C.52:25-24.2) are to be extended to prior to the issuance of a Notice of Intent to Award; and (4) the term "bids" in subparagraph (f) of subsection a. of section 7 of P.L.1954, c.48 (C.52:34-12) is not to include pricing which will be revealed to all responsive bidders during the negotiation process.
Under the bill, the Commissioner of Human Services may waive any laws or regulations as necessary to effectuate the bill's provisions.
