2025 -- H 5173

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     

     Introduced By: Representatives McGaw, Shekarchi, Hull, Craven, Corvese, J. Lombardi,
Kazarian, Diaz, Donovan, and Spears

     Date Introduced: January 24, 2025

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Findings of fact

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     The Rhode Island general assembly recognizes that glucagon auto-injectors are life-saving

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medications, that must be administered quickly to be effective. Such administration is often done

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by persons who are not health care professionals, and is done in an emergency situation.

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Accordingly, it is in the best interests of the people of the state to promote the widespread

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availability of glucagon, that does not require reconstitution. Hypoglycemia, or low blood glucose,

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is a barrier to diabetes control, leads to worse clinical outcomes, stress, increased cost of care and

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polypharmacy. For unconscious patients, and those unable to ingest oral glucose, glucagon in the

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ambulatory setting is indicated, but often underutilized, due to excessive cost.

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     SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance

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Policies" is hereby amended by adding thereto the following section:

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     27-18-95. Glucagon hypoglycemia medications..

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     Every individual or group health insurance contract, plan, or policy that provides

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prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state

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on or after January 1, 2026, shall provide coverage for at least one type of glucagon auto-injector,

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nasal spray or formulation not requiring reconstitution. There shall be no copayment required and

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no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non-

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reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan

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year. A deductible may be applied to health plans that are paired with federally qualified health

 

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savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan

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from implementing this benefit prior to January 1. 2026.

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     SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-19-87. Glucagon hypoglycemia medications..

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     Every individual or group health insurance contract, plan, or policy that provides

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prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state

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on or after January 1, 2026, shall provide coverage for at least one type of glucagon auto-injector,

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nasal spray or formulation not requiring reconstitution. There shall be no copayment required and

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no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non-

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reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan

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year. A deductible may be applied to health plans that are paired with federally qualified health

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savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan

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from implementing this benefit prior to January 1. 2026.

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     SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-20-83. Glucagon hypoglycemia medications..

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     Every individual or group health insurance contract, plan, or policy that provides

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prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state

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on or after January 1, 2026, shall provide coverage for at least one type of glucagon auto-injector,

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nasal spray or formulation not requiring reconstitution. There shall be no copayment required and

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no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non-

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reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan

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year. A deductible may be applied to health plans that are paired with federally qualified health

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savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan

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from implementing this benefit prior to January 1. 2026.

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     SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance

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Organizations" is hereby amended by adding thereto the following section:

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     27-41-100. Glucagon hypoglycemia medications..

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     Every individual or group health insurance contract, plan, or policy that provides

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prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state

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on or after January 1, 2026, shall provide coverage for at least one type of glucagon auto-injector,

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nasal spray or formulation not requiring reconstitution. There shall be no copayment required and

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no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non-

 

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reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan

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year. A deductible may be applied to health plans that are paired with federally qualified health

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savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan

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from implementing this benefit prior to January 1. 2026.

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     SECTION 6. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would require, commencing January 1, 2026, group health plans and health

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insurance issuers that provide prescription benefits to cover at least one type of glucagon auto-

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injector, nasal spray, or formulation which does not require reconstitution to treat hypoglycemia

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with two (2) glucagon auto-injectors every plan year. No copayment or deductible would be

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required to obtain prescribed glucagon medications.

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     This act would take effect upon passage.

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