Bill Introduced to Manage Prescription Drug Costs for Medicaid Beneficiaries

Bill Introduced to Manage Prescription Drug Costs for Medicaid Beneficiaries - Healthcare Law Update - June 2025 - Brach Eichler
BACK TO INSIGHTS     Articles

6/1/2025

The Equitable Drug Pricing and Patient Access Act, introduced in the New Jersey Assembly on April 10, 2025, would require the reimbursement rate for prescription drug services paid to a pharmacy providing prescription drug services to Medicaid beneficiaries to not be less than the national average drug acquisition cost of the drug plus a Medicaid fee-for-service professional dispensing fee of $10.92. If enacted, the Bill would apply to Medicaid fee-for-service and Medicaid managed care plans. Additionally, the Bill would mandate that all Medicaid managed care contracts include pharmacy choice as a benefit, so enrollees could choose any qualified pharmacy that is a contracting provider, and no qualified pharmacy would be denied the right to become a contracting provider under the same terms and conditions as existing contracting pharmacies, as long as the pharmacy accepts the contract’s terms.

Click Here to read the entire June 2025 Healthcare Law Update now!

For more information, contact:
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Edward Hilzenrath | 973.403.3114 | ehilzenrath@bracheichler.com
Rebecca T. Falk | 973.364.8393 | rfalk@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare