Fifteen New Statutes in New Jersey Impacting Healthcare

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As a follow-up to our previous post, below is a list of fifteen New Jersey Statutes that either have been approved by the Governor or await the Governor’s approval.

New Jersey Approves Hospital Wrap-Around Services    

S1676: As noted in our previous update, Governor Murphy previously issued a conditional veto of this bill, which allows hospitals to provide wrap-around services for individuals who are homeless or housing insecure. After factoring in the Governor’s comments, the bill has now been approved.

Creation of Long-Term Care Ombudsman

A4484: This bill, requiring the State Long-Term Care Ombudsman (“Ombudsman”) to establish a long-term care advocacy and educational training program, passed both the State Assembly and Senate. Under the bill, the Ombudsman is required to establish an annual long-term care training program to address the following subjects: the rights of residents of long-term care facilities; fostering choice and independence among residents of long-term care facilities; identifying and reporting abuse, neglect, or exploitation of residents of long-term care facilities; long-term care facility ownership; updates on State and federal guidelines, laws, and regulations that pertain to long-term care facilities; and issues, trends, and policies that impact the rights of long-term care residents. The training program is to be offered to residents of long-term care facilities, those residents’ family members, advocacy organizations, government agencies, and long-term care facility employees.  The bill will become law if executed by the Governor.

Statutes on Opioid Addiction and Antidote

A5703:  This bill, which has already been approved by the Governor, requires a health insurance company who is authorized to issue health benefits plans in this state, as well as the Medicaid program, the NJ FamilyCare Program, the State Health Benefits Program, and the School Employees’ Health Benefits Program, to provide coverage for an opioid antidote without imposing prior authorization requirements or other utilization management requirements, provided that the treatment is: (1) prescribed or administered to the eligible member by a licensed medical practitioner who is authorized to prescribe or administer that treatment pursuant to State and federal law or (2) dispensed to the eligible member by a licensed pharmacist under a standing order to dispense an opioid antidote pursuant to section 1 of P.L.2017, c.88 (C.45:14-67.2), which allows pharmacists to dispense opioid antidotes to any person without an individual prescription. The bill defines “opioid antidote" to mean naloxone hydrochloride, or any other similarly acting drug approved by the FDA for self-administration for the treatment of an opioid overdose.

A5595: This bill, which has been approved and is now law, makes the retail price of opioid antidotes readily available to consumers by including this information in the New Jersey Prescription Drug Retail Price Registry (“NJPDRPR”).    The NJPDRPR makes up-to-date retail price information for the 150 most frequently prescribed prescription drugs in the state readily available to consumers. It indicates the actual price to be paid to the pharmacy by a retail purchaser. This bill includes opioid antidotes on the list of frequently prescribed prescription drugs. Under the bill, “opioid antidote” is defined as any drug, regardless of dosage amount or method of administration, which has been approved by the FDA for the treatment of an opioid overdose, and includes naloxone hydrochloride, commonly known as Narcan.

S3491:  This bill, which has already been approved by the Governor, permits any person to acquire, furnish or administer to another person opioid antidotes, and expands access to opioid antidotes including, among other circumstances, without an individual prescription. 

S3803: This bill permits certain paramedics to administer buprenorphine, which is a form of medication-assisted treatment that helps curb cravings resulting from opioid use disorder. Under the bill, a paramedic who has responded to an emergency as a member of a dispatched mobile intensive care unit may administer buprenorphine, under the medical direction of a licensed, supervising physician, to an individual following the emergent administration of an opioid antidote to the individual, provided that the paramedic administering the buprenorphine: (1) is providing emergency medical services through a program that is registered with the United States Attorney General pursuant to subsection (j) of 21 U.S.C. s.823; (2) administers the buprenorphine consistent with all applicable requirements of federal law; and (3) has completed supervised comprehensive training and competency assessments within a mobile intensive care unit regarding which specific medical conditions necessitate the administration of buprenorphine, buprenorphine dosage requirements, and required medical documentation following the administration of buprenorphine. This bill has already been approved by the Governor.

Telemedicine and Medical Cannabis

S619: This bill, which has been approved and is now law, permits patients to be authorized for medical cannabis and to have written instructions for medical cannabis issued to the patient using telemedicine and telehealth. Specifically, for a period of 270 days following the effective date of the bill, a health care provider may authorize a patient who is a resident of a long-term care facility, has a developmental disability, is terminally ill, is receiving hospice care from a licensed hospice care provider, or is housebound as certified by the patient’s physician, for the medical use of cannabis using telemedicine and telehealth. Thereafter, a health care provider may initially authorize any patient for the medical use of cannabis using telemedicine and telehealth, provided that, except in the case of a patient who is a resident of a long-term care facility, has a developmental disability, is terminally ill, is receiving hospice care from a licensed hospice care provider, or is housebound as certified by the patient’s physician, the patient has had at least one previous in-office consultation with the health care provider prior to the patient’s authorization for the medical use of cannabis. Following the initial authorization, the patient is to have at least one in-office consultation with the health care provider on an annual basis in order for the patient to receive continued authorization for the use of medical cannabis. 

New Statute on Pharmacy Benefit Managers

S249: This bill, which unanimously passed both the State Assembly and Senate and awaits the Governor’s signature, requires any contract entered into by a Medicaid managed care organization, or by the Division of Medical Assistance and Health Services in the Department of Human Services (“DHS”), for the provision of pharmacy benefits management services under the Medicaid Program to require the pharmacy benefits manager to disclose: (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. Information reported by pharmacy benefits managers under the bill will be confidential and will not be subject to disclosure under the Open Public Records Act. 

Expanding Providers Who Can Administer Vaccines

A5212: This statute provides that a dentist may administer the influenza vaccine or the human papillomavirus vaccine to a patient who is 18 years of age or older. It also provides that a dentist may administer immunizations to patients who are 18 years of age or older during a public health emergency which are intended to prevent or reduce the transmission of the disease that is the basis for the declared public health emergency. The bill passed both the Senate and Assembly and will become law once the Governor executes the bill.

Expansion of the SBYSP for Mental Health Services

A4435: This bill amends the statute governing the School Based Youth Services Program (“SBYSP”), which is located in host schools, and is currently operated by The Department of Children and Families’ Office of School-Linked Services within the Division of Family and Community Partnerships. SBYSP services include, among others, mental health counseling, employment counseling, and substance abuse education/prevention. After applying certain factors, under the bill, priority for SBYSP grants will first be given to new applicant school districts and school districts seeking to expand current programs that include in their application a center or other entity that focuses on providing individual, family, and group clinical mental health counseling services to students.  The schools will offer access to mental health counseling services during, before, or after school hours to students either in-person or remotely through the use of telehealth or telemedicine services, as applicable. The bill passed both the Senate and Assembly and awaits the Governor’s signature.

New Software for SNAP Benefits

A5880: This bill requires the DHS to develop and maintain a mobile-friendly software for recipients of the Supplemental Nutrition Assistance Program (“SNAP”). The mobile software program will include, but not be limited to, functionality that allows a user of the mobile software program who is a recipient of SNAP benefits to view the user’s SNAP case status and the current benefits the user receives, upload and submit required documents for continued participation in SNAP and track the current processing status of those documents, and receive notices and updates regarding important deadlines or actions. The mobile-friendly software will also be required to be made available free of charge and in multiple languages. The bill passed both the Senate and Assembly and will become law if the Governor executes the bill.

Creation of Risk Reduction Model for Prescription Drug Services

S887: This bill has already been approved and is now law. It requires the Division of Medical Assistance and Health Services in the DHS to contract with a third party entity to apply a risk reduction model to prescription drug services provided under the Medicaid program for the purpose of identifying and reducing simultaneous, multi-drug medication-related risk and adverse drug events, enhancing compliance and quality of care, and improving health-related outcomes while reducing total cost of care in a measurable and reportable manner. To carry out this purpose, the model will leverage Medicaid prescription drug claims data, pharmacokinetic and pharmacodynamic sciences, appropriate technologies, clinical call centers located in New Jersey and staffed by board-certified pharmacists, and include coordination of services with a network of local community pharmacies located throughout the state. For the duration of the contract, the division will share the medical and pharmacy claims data for all Medicaid beneficiaries with the third party entity administering the model for the purposes of effectuating the model, which claims data will include historical data.

New Jersey Easy Enrollment Health Insurance Program for the Un-insured

S3238: This bill, which passed both houses and awaits the Governor’s signature, establishes a program to help improve access to health care. The bill requires the Department of Banking and Insurance (“DOBI”) to establish and operate the New Jersey Easy Enrollment Health Insurance Program (the “program”). The program would identify which uninsured residents would be interested in obtaining minimum essential coverage and if they are eligible for insurance affordability assistance. DOBI is required to integrate the program with the State-based health insurance exchange. Residents who qualify for affordability assistance and are interested in obtaining insurance would be contacted through the program to receive assistance enrolling in a plan.

Further Changes to the Garden State Health Plan

A5825: This bill, which has already been approved, changes the effective date of the new Garden State Health Plan for the School Employees’ Health Benefits Program and for local education employers, as established by P.L.2020, c.44, from July 1, 2021 to January 1, 2022. This bill also clarifies that charter school and renaissance school employers do not have to implement the provisions of P.L.2020, c.44 unless they have a collective negotiation agreement with any of their employees in effect on or after the effective date of P.L.2020, c.44, July 1, 2020. Among other changes, this bill provides that for any period of time during which the school district as an employer does not have to pay a premium or periodic charge for any health care benefits plan or program provided to its employees through the School Employees’ Health Benefits Program, then an employee enrolled in such plan or program will not be required to make the employee’s contribution toward that premium or periodic charge during that period of time. The bill also requires a board of education and the majority representative of its employees to engage in collective negotiations to substantially mitigate the financial impact of the difference when the net cost, which is the cost after deducting employee contributions, to the employer for health care benefits is lower than the cost to the employer would be compared to the New Jersey Educators Health Plan. The bill also requires any school district with an increase in net cost as a result of the changes in P.L.2020, c.44 to commence negotiations immediately, unless mutually agreed upon by the employer and the majority representative of employees to opt to substantially mitigate the financial impact to the employer as part of the next collective negotiations agreement.

Premium Wipe Out for NJ Family Care

S3798: The bill generally prohibits requiring enrollees in NJ FamilyCare to pay premiums as a condition of participation in the program, but premiums may still be required for enrollees who exceed income limits but elect to buy into NJ FamilyCare. The bill eliminates a provision in the current law that requires certain children who were voluntarily dis-enrolled from employer-sponsored group insurance coverage to be deemed ineligible for enrollment in NJ FamilyCare for a certain period, and provides that no waiting periods may be imposed against any applicant for the program who is otherwise eligible for enrollment. The bill also requires DOBI, in consultation with the Commissioner of Human Services, to take steps to ensure the full incorporation of the Medicaid, NJ FamilyCare and NJ FamilyCare Advantage Programs on the State’s health insurance Exchange and the individual health coverage marketplace. This bill has already been approved by the Governor.