2026 -- H 7189

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LC003517

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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A N   A C T

RELATING TO INSURANCE -- PHARMACY FREEDOM OF CHOICE -- FAIR

COMPETITION AND PRACTICES

     

     Introduced By: Representatives Kislak, Fogarty, McGaw, Boylan, Speakman, Donovan,
Spears, and Handy

     Date Introduced: January 21, 2026

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-29.1 of the General Laws entitled "Pharmacy Freedom of Choice

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— Fair Competition and Practices" is hereby amended by adding thereto the following section:

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     27-29.1-12. Fair pharmacy reimbursement and anti-discrimination.

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     (a) Reimbursement parity.

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     A pharmacy benefit manager shall not reimburse a non-affiliated pharmacy or pharmacist

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in an amount less than the net effective reimbursement, inclusive of all fees, adjustments,

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incentives, and other remuneration, paid directly or indirectly to an affiliated pharmacy or

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pharmacist for the same drug or service.

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     (b) Anti-discrimination.

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     A pharmacy benefit manager shall not impose contractual terms, reimbursement

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methodologies, performance metrics, or other requirements that have the effect of reimbursing non-

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affiliated pharmacies or pharmacists at a lower rate than affiliated pharmacies or pharmacists for

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the same drug or service.

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     (c) Transparency of affiliated reimbursement.

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     Upon request by the office of the health insurance commissioner (“OHIC”), a pharmacy

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benefit manager shall provide reimbursement data reasonably necessary to verify compliance with

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this section, including data relating to affiliated pharmacies.

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     (d) Enforcement.

 

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     This section shall be enforced by OHIC and the attorney general pursuant to their existing

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authority under law.

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     (e) Medicaid applicability.

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     All Medicaid managed care organizations, and all pharmacy benefit managers contracted

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by or on behalf of Medicaid managed care organizations, shall comply with the provisions of this

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section with respect to all Medicaid pharmacy benefits, whether administered directly or through a

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pharmacy benefit manager.

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     (f) Prohibition on evasion.

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     A pharmacy benefit manager, insurer, or Medicaid managed care organization shall not

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avoid compliance with this section through affiliation structures, subcontracting, differential

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pricing metrics, reimbursement methodologies, or contractual arrangements designed to favor

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affiliated pharmacies or pharmacists.

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     (g) Rulemaking.

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     The OHIC may promulgate and adopt rules and regulations necessary to implement and

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enforce this section.

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     SECTION 2. 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 -- PHARMACY FREEDOM OF CHOICE -- FAIR

COMPETITION AND PRACTICES

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     This act would require fair pharmacy reimbursement from a pharmacy benefit manager to

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a non-affiliated pharmacy or pharmacist and also provide anti-discrimination prohibitions by

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pharmacy benefit managers in regard to non-affiliated pharmacies or pharmacists.

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     This act would take effect upon passage.

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