30:4D-6z Department of Human Services, HIV preexposure prophylaxis, HIV postexposure prophylaxis.
376 words·~2 min read·
/nj/title-30/chapter-4d/30-4d-6zA research copy — for the controlling text, always check the official state or federal source. Not legal advice.
11. a.
(1)Notwithstanding any State law or regulation to the contrary, and except as provided in paragraph
(2)of this subsection, the Department of Human Services shall ensure that the provision of benefits for HIV preexposure prophylaxis and HIV postexposure prophylaxis furnished without an individual prescription pursuant to the requirements of section 2 of P.L.2025, c.196 (C.45:14-67.13) to eligible persons under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), shall be provided without the imposition of any prior authorization or step therapy requirements.
(2)If the federal Food and Drug Administration has authorized or approved one or more therapeutic equivalents of a drug, device, or product for the prevention of HIV and AIDS, paragraph
(1)of this subsection shall not be construed to require the department to ensure coverage of all therapeutically equivalent versions without prior authorization or step therapy, if at least one version is covered without prior authorization or step therapy.
b. Reimbursement issued under this section to a pharmacist shall be at a rate that is no less than the rate provided by the Department of Human Services to other non-physician practitioners if the reimbursement is for a service or procedure that meets the following criteria:
(1)the service or procedure is within the scope of practice of the treating pharmacist; and
(2)the service or procedure would otherwise be covered by the department if provided by a healthcare provider, including a physician, advanced practice nurse, or physician assistant.
c. The Department of Human Services shall grant a licensed pharmacist receiving reimbursement under this section the same rights of participation, plan admission, and registration as may be granted by the department to a healthcare provider, including a physician, advanced practice nurse, or physician assistant, who is reimbursed for an identical service.
d. As used in this section:
“HIV preexposure prophylaxis” means the same as that term is defined in section 1 of P.L.2025, c.196 (C.45:14-67.12).
“HIV postexposure prophylaxis” means the same as that term is defined in section 1 of P.L.2025, c.196 (C.45:14-67.12).
“Step therapy” means requiring that a lower-cost alternative to HIV preexposure prophylaxis or HIV postexposure prophylaxis be shown to have been ineffective as a condition of providing prescription benefits coverage for the prophylaxis.
L.2025, c.196, s.11.