2026 -- H 7534 | |
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LC004623 | |
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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 BUSINESSES AND PROFESSIONS -- PHARMACIES | |
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Introduced By: Representatives Tanzi, Stewart, Giraldo, Edwards, Bennett, Diaz, | |
Date Introduced: February 06, 2026 | |
Referred To: House Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 5-19.1 of the General Laws entitled "Pharmacies" is hereby amended |
2 | by adding thereto the following section: |
3 | 5-19.1-39. Tobacco cessation therapy prescriptive authority. |
4 | (a) A pharmacist who is licensed pursuant to this chapter and who meets the requirements |
5 | of this section may prescribe and dispense FDA-approved tobacco cessation drug therapies to a |
6 | qualified patient pursuant to rules and regulations adopted by the board of pharmacy, subject to the |
7 | approval of the director of health in consultation with the director of behavioral healthcare, |
8 | developmental disabilities and hospitals. |
9 | (b) For the purposes of this section, "qualified patient" means a patient who: |
10 | (1) Is at least eighteen (18) years of age or of minimum age based on the most recent |
11 | guidance provided by the FDA; |
12 | (2) Is willing to participate in a structured tobacco cessation program consisting of an initial |
13 | evaluation and appropriate follow-up visits with the pharmacist prescribing tobacco cessation |
14 | products; and |
15 | (3) Has been educated on symptoms of nicotine toxicity, common and/or severe adverse |
16 | effects of prescribed medication(s), and when to seek medical treatment. |
17 | (c) Prior to prescribing tobacco cessation therapies, the pharmacist shall have completed |
18 | tobacco cessation education approved by the state board of pharmacy. |
19 | (d) The pharmacist shall refer or consult prior to prescribing regarding high-risk patients |
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1 | or patients with an identified contraindication to FDA-approved tobacco cessation drug therapies |
2 | to the patient's primary care provider, as applicable, or to another provider, as appropriate. |
3 | (e) All pharmacists participating in prescribing therapy for tobacco cessation shall follow |
4 | the most updated guidelines and standards of care as approved by the board of pharmacy, subject |
5 | to the approval of the director of the department of health in consultation with the director of |
6 | behavioral healthcare, developmental disabilities and hospitals. |
7 | (1) Pharmacists shall implement the most updated clinical practice guidelines to help |
8 | patients quit using all forms of tobacco. |
9 | (2) Pharmacists' services shall include an educational component to include counseling on |
10 | medication therapies and cessation strategies as well as referral to sources provided by the |
11 | department of health. |
12 | (f) Notification of the patient screening, the prescription record and the follow-up care plan |
13 | shall be provided to the patient's primary care provider, as applicable, within five (5) business days |
14 | following the prescribing of a tobacco cessation product. |
15 | (g) The definition of a qualified patient is subject to adaptation pursuant to rules and |
16 | regulations adopted by the board of pharmacy, subject to the approval of the director of the |
17 | department of health in consultation with the director of behavioral healthcare, developmental |
18 | disabilities and hospitals. |
19 | (h) Tobacco cessation drug therapies shall be covered by Medicaid upon approval of the |
20 | Medicaid section 1115 demonstration waiver to be submitted by the secretary of the executive |
21 | office of health and human services pursuant to chapter 12.4 of title 42. |
22 | SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance |
23 | Policies" is hereby amended by adding thereto the following section: |
24 | 27-18-96. Coverage for pharmacists' services. |
25 | (a) Every group health insurance contract, or every group hospital or medical expense |
26 | insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by |
27 | any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services |
28 | within the lawful scope of practice of pharmacists pursuant to § 5-19.1-2 if the plan would have |
29 | provided coverage if the service had been performed by a physician, advanced practice nurse, or |
30 | physician assistant. No nonprofit medical service corporation may require supervision, signature, |
31 | or referral by any other healthcare provider as a condition of reimbursement to a pharmacist; |
32 | provided that, no nonprofit medical service corporation may be required to pay for duplicative |
33 | services actually rendered by both a pharmacist and any other healthcare provider. |
34 | (b) The health plan shall include an adequate number of pharmacists in its network of |
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1 | participating medical providers. The participation of pharmacies in the plan network's drug benefit |
2 | does not satisfy the requirement that plans include pharmacists in their networks of participating |
3 | medical providers. |
4 | (c) The healthcare benefits outlined in this section shall apply only to services delivered |
5 | within the health insurer's provider network; provided that, all health insurers shall be required to |
6 | provide coverage for those benefits mandated by this section outside of the health insurer's provider |
7 | network where it can be established that the required services are not available from a provider in |
8 | the health insurer's network. |
9 | SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service |
10 | Corporations" is hereby amended by adding thereto the following section: |
11 | 27-19-88. Coverage for pharmacists' services. |
12 | (a) Every group health insurance contract, or every group hospital or medical expense |
13 | insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by |
14 | any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services |
15 | within the lawful scope of practice of pharmacists pursuant to § 5-19.1-2 if the plan would have |
16 | provided coverage if the service had been performed by a physician, advanced practice nurse, or |
17 | physician assistant. No nonprofit medical service corporation may require supervision, signature, |
18 | or referral by any other healthcare provider as a condition of reimbursement to a pharmacist; |
19 | provided that, no nonprofit medical service corporation may be required to pay for duplicative |
20 | services actually rendered by both a pharmacist and any other healthcare provider. |
21 | (b) The health plan shall include an adequate number of pharmacists in its network of |
22 | participating medical providers. The participation of pharmacies in the plan network's drug benefit |
23 | does not satisfy the requirement that plans include pharmacists in their networks of participating |
24 | medical providers. |
25 | (c) The healthcare benefits outlined in this section shall apply only to services delivered |
26 | within the health insurer's provider network; provided that, all health insurers shall be required to |
27 | provide coverage for those benefits mandated by this section outside of the health insurer's provider |
28 | network where it can be established that the required services are not available from a provider in |
29 | the health insurer's network. |
30 | SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service |
31 | Corporations" is hereby amended by adding thereto the following section: |
32 | 27-20-84. Coverage for pharmacists' services. |
33 | (a) Every group health insurance contract, or every group hospital or medical expense |
34 | insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by |
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1 | any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services |
2 | within the lawful scope of practice of pharmacists pursuant to § 5-19.1-2 if the plan would have |
3 | provided coverage if the service had been performed by a physician, advanced practice nurse, or |
4 | physician assistant. No nonprofit medical service corporation may require supervision, signature, |
5 | or referral by any other healthcare provider as a condition of reimbursement to a pharmacist; |
6 | provided that, no nonprofit medical service corporation may be required to pay for duplicative |
7 | services actually rendered by both a pharmacist and any other healthcare provider. |
8 | (b) The health plan shall include an adequate number of pharmacists in its network of |
9 | participating medical providers. The participation of pharmacies in the plan network's drug benefit |
10 | does not satisfy the requirement that plans include pharmacists in their networks of participating |
11 | medical providers. |
12 | (c) The healthcare benefits outlined in this section shall apply only to services delivered |
13 | within the health insurer's provider network; provided that, all health insurers shall be required to |
14 | provide coverage for those benefits mandated by this section outside of the health insurer's provider |
15 | network where it can be established that the required services are not available from a provider in |
16 | the health insurer's network. |
17 | SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance |
18 | Organizations" is hereby amended by adding thereto the following section: |
19 | 27-41-101. Coverage for pharmacists' services. |
20 | (a) Every group health insurance contract, or every group hospital or medical expense |
21 | insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by |
22 | any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services |
23 | within the lawful scope of practice of pharmacists pursuant to § 5-19.1-2 if the plan would have |
24 | provided coverage if the service had been performed by a physician, advanced practice nurse, or |
25 | physician assistant. No nonprofit medical service corporation may require supervision, signature, |
26 | or referral by any other healthcare provider as a condition of reimbursement to a pharmacist; |
27 | provided that, no nonprofit medical service corporation may be required to pay for duplicative |
28 | services actually rendered by both a pharmacist and any other healthcare provider. |
29 | (b) The health plan shall include an adequate number of pharmacists in its network of |
30 | participating medical providers. The participation of pharmacies in the plan network's drug benefit |
31 | does not satisfy the requirement that plans include pharmacists in their networks of participating |
32 | medical providers. |
33 | (c) The healthcare benefits outlined in this section shall apply only to services delivered |
34 | within the health insurer's provider network; provided that, all health insurers shall be required to |
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1 | provide coverage for those benefits mandated by this section outside of the health insurer's provider |
2 | network where it can be established that the required services are not available from a provider in |
3 | the health insurer's network. |
4 | 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 BUSINESSES AND PROFESSIONS -- PHARMACIES | |
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1 | This act would add new sections which set forth conditions for pharmacists to prescribe |
2 | tobacco cessation drug therapies, including education approved by the state board of pharmacy. |
3 | The cessation therapies pharmacists’ services for cessation therapies would be covered by all health |
4 | insurance carriers on or after January 1, 2027. |
5 | This act would take effect upon passage. |
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