ASSEMBLY APPROPRIATIONS COMMITTEE

STATEMENT TO

ASSEMBLY, No. 6293

STATE OF NEW JERSEY

DATED:  DECEMBER 18, 2025

      The Assembly Appropriations Committee reports favorably Assembly Bill No. 6293.

      As reported, this bill permits pharmacists to dispense HIV prophylaxis without an individual prescription under certain circumstances, and requires prescription benefits coverage for prophylaxis furnished according to the bill’s provisions.  HIV prophylaxis includes HIV preexposure prophylaxis (PrEP) for a person who anticipates engaging in conduct that risks HIV infection, and HIV postexposure prophylaxis (PEP) for a person who may have been exposed to HIV.

      The bill authorizes pharmacists to dispense PrEP and PEP without an individual prescription under a standing order by the Commissioner of Health or, if the commissioner is not a physician, the Deputy Commissioner for Public Health Services.  A standing order will be issued to a pharmacist, provided the pharmacist completes training provided or approved by the Department of Health, and certifies that the pharmacist will meet the bill’s requirements. 

      A patient may receive up to a 90-day supply of PrEP without a prescription in a two-year period, but must obtain a prescription to continue receiving PrEP.  A pharmacist must counsel the patient on the use of PrEP, and confirm that the patient has not received PrEP without an individual prescription in the past two years. 

      A pharmacist may dispense PEP if: the pharmacist confirms with the patient that the exposure to HIV occurred within the previous 72 hours, the patient meets the clinical criteria for PEP, and the pharmacist counsels the patient on the use of PEP.

      A pharmacist ordering or providing PrEP or PEP must comply with the standards of care required under Centers for Disease Control and Prevention (CDC) guidelines for a physician or other health professional ordering or providing the identical service. If the CDC guidelines are unavailable, the department will establish guidelines for pharmacists to order or provide PrEP or PEP according to the same standard of care required for a physician or other health professional providing the same service.

      A pharmacist who dispenses PrEP or PEP based on information provided by a patient or the patient's legal representative will not to be subject to civil liability, criminal prosecution, disciplinary action, or adverse professional licensing action for injury or damages resulting from reliance on such information.

      The bill requires health benefits plans that include prescription benefits, the State Health Benefits Program, the School Employees’ Health Benefits Program, and the State Medicaid program to cover PrEP and PEP without prior authorization or step therapy requirements.  If therapeutic equivalents to prevent HIV and AIDS are approved by the federal government, health plans may apply prior authorization or step therapy requirements to other formulations of the treatment, provided at least one formulation is covered without prior authorization or step therapy. 

      Reimbursements to a pharmacist will be at a rate that is no less than the rate paid by the health plan to other non-physician practitioners, if the reimbursement is for a service or procedure that meets the bill’s criteria. 

      As reported by the committee, Assembly Bill No. 6293 is identical to Senate Bill No. 2019 (2R), which was also reported by the committee on this date.

FISCAL IMPACT:

      The Office of Legislative Services (OLS) concludes that authorizing pharmacists to dispense HIV prophylaxis to a patient once every two years without an individual prescription, when certain conditions are met, will increase annual State expenditures under the NJ FamilyCare program.  These costs would concomitantly increase annual State revenue in the form of federal Medicaid cost reimbursements.

      The OLS anticipates that requiring the State Health Benefits Program and the School Employees’ Health Benefits Program to provide coverage for HIV prophylaxis dispensed to a member once every two years without an individual prescription may increase State and local government expenditures by an indeterminate amount if more brand drugs are issued as a result of the bill.