2021 -- H 5611

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LC000737

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACIES -- PRESCRIPTIONS

     

     Introduced By: Representatives Noret, Casimiro, Vella-Wilkinson, Alzate, Corvese,
Craven, Amore, Casey, S Lima, and Lombardi

     Date Introduced: February 18, 2021

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 5-19.1-19 of the General Laws in Chapter 5-19.1 entitled

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"Pharmacies" is hereby amended to read as follows:

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     5-19.1-19. Pharmacists -- Substitution of drugs.

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     (a) Pharmacists when dispensing a prescription shall, unless requested otherwise by the

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individual presenting the prescription in writing, substitute drugs containing all the same active

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chemical ingredients of the same strength, quantity, and dosage form as the drug requested by the

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prescriber from approved prescription drug products in accordance with the provisions of § 21-31-

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16, unless ordered by the prescribing physician to dispense as brand name necessary on the

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prescription form, or if the prescriber gives oral direction to that effect to the dispensing pharmacist.

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The requirements of this section shall not apply to an order to dispense a drug for immediate

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administration to a licensed hospital, nursing facility or hospice facility in-patient. The pharmacist

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will make a product selection from approved prescription drug products and shall pass the savings

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on to the ultimate consumer. When a drug product selection is made, the pharmacist shall indicate

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the product dispensed on the written prescription or on the oral prescription, which has been

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reduced to writing, or product information may be maintained on a computerized system if

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information is readily retrievable.

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     (b) As used in the section, "cost sharing" means the share of costs, covered by insurance,

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which is paid out of pocket. This term includes deductibles, coinsurance, and copayments, or

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similar charges, but it does not include premiums, balance billing amounts for non-network

 

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providers, or the cost of non-covered services.

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     (c) Pharmacists, when dispensing a prescription, shall inform the customer whether their

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available cost-sharing benefits exceed the actual retail price of the prescription sought, in the

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absence of prescription drug coverage.

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     SECTION 2. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits" is

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hereby amended by adding thereto the following section:

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     27-20.8-3. Pharmacy benefit manager.

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     (a) As used in this section, "pharmacy benefit manager" means a person or entity who

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contracts with a pharmacy on behalf of an insurer, health plan, or third-party administrator to

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administer or manage prescription drug benefits.

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     (b) No medical insurance carrier or pharmacy benefit manager shall penalize or prohibit in

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any manner, a pharmacy's disclosure to an individual purchasing prescription medication relative

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to information regarding the cost of the prescription medication to the individual or the availability

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of any therapeutically equivalent alternative medications or alternative methods of purchasing the

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prescription medication, including, but not limited to, paying a cash price, that are less expensive

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than the cost of the prescription medication available to the individual, as required by § 5-19.1-19.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACIES -- PRESCRIPTIONS

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     This act would require pharmacists to notify their customers whether their cost sharing

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benefits exceed the actual retail price of the prescription sought, in the absence of prescription drug

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coverage. It would also prevent medical insurance companies and pharmacy benefit managers from

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penalizing a pharmacy for informing their prescription purchasers of alternative substitute drugs

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that are less expensive than those sought.

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     This act would take effect upon passage.

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