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:

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

"Pharmacies" is hereby amended to read as follows:

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

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

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

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

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

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

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

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

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

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

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

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

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

information is readily retrievable.

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

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

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

providers, or the cost of non-covered services.

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

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

absence of prescription drug coverage.

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

hereby amended by adding thereto the following section:

     27-20.8-3. Pharmacy benefit manager.

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

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

administer or manage prescription drug benefits.

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

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

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

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

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

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

     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

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

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

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

that are less expensive than those sought.

     This act would take effect upon passage.

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