2024 -- S 2395 | |
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LC004702 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2024 | |
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A N A C T | |
RELATING TO INSURANCE -- PHARMACY FREEDOM OF CHOICE -- FAIR | |
COMPETITION AND PRACTICES | |
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Introduced By: Senators Ujifusa, Miller, Valverde, Murray, Lauria, DiMario, Zurier, | |
Date Introduced: February 12, 2024 | |
Referred To: Senate Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Section 27-29.1-7 of the General Laws in Chapter 27-29.1 entitled "Pharmacy |
2 | Freedom of Choice — Fair Competition and Practices" is hereby amended to read as follows: |
3 | 27-29.1-7. Regulation of pharmacy benefits managers. |
4 | (a) Pharmacy benefits managers shall be included within the definition of third-party |
5 | administrator under chapter 20.7 of this title and shall be regulated as such. The annual report filed |
6 | by third-party administrators with the department of business regulation shall include: contractual |
7 | language that provides a complete description of the financial arrangements between the third-party |
8 | administrator and each of the insurers covering benefit contracts delivered in Rhode Island; and if |
9 | the third-party administrator is owned by or affiliated with another entity or entities, it shall include |
10 | an organization chart and brief description that shows the relationships among all affiliates within |
11 | a holding company or otherwise affiliated. The reporting shall be in a format required by the |
12 | director and filed with the department as a public record as defined and regulated under chapter 2 |
13 | of title 38. |
14 | (b) A pharmacy benefit manager may not reimburse a pharmacy or pharmacist for a |
15 | prescription drug or pharmacy service in an amount less than the national average drug acquisition |
16 | cost for the prescription drug or pharmacy service at the time the drug is administered or dispensed, |
17 | plus a professional dispensing fee equal to the current Medicaid covered outpatient prescription |
18 | drug reimbursement dispensing fee for Rhode Island; provided that, if the national average drug |
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1 | acquisition cost is not available at the time a drug is administered or dispensed, a pharmacy benefit |
2 | manager shall reimburse in an amount that is not less than the wholesale acquisition cost of the |
3 | drug, as defined in 42 U.S.C. § 1395w-3a(c)(6)(B), plus the professional dispensing set forth |
4 | herein. For purposes of this section, “National average drug acquisition cost” means the monthly |
5 | survey of retail pharmacies conducted by the federal Centers for Medicare and Medicaid Services |
6 | to determine the average acquisition cost for Medicaid covered outpatient drugs. |
7 | (c) The office of the health insurance commissioner (OHIC) may enforce the provisions of |
8 | this chapter by imposing civil fines up to ten thousand dollars ($10,000) per violation or by taking |
9 | any other enforcement actions not prohibited by law. Nothing in this chapter shall preclude the |
10 | attorney general from also taking actions against pharmacy benefit managers to enforce any laws, |
11 | including provisions set forth in this section. |
12 | (d) Should any provision of this section be found unconstitutional, preempted, or otherwise |
13 | invalid, the remainder of this section, and the application of the provisions to persons or |
14 | circumstances other than those as to which it is held invalid, shall not be affected by that invalidity. |
15 | SECTION 2. This act shall take effect upon passage. |
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LC004702 | |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO INSURANCE -- PHARMACY FREEDOM OF CHOICE -- FAIR | |
COMPETITION AND PRACTICES | |
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1 | This act would ensure that independent pharmacies are protected from pharmacy benefit |
2 | discrimination toward non-affiliated pharmacies and help protect consumers’ ability to choose |
3 | local, independent pharmacies. |
4 | This act would take effect upon passage. |
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LC004702 | |
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