2025 -- S 0165 | |
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LC001208 | |
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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 -- PHARMACY FREEDOM OF CHOICE -- FAIR | |
COMPETITION AND PRACTICES | |
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Introduced By: Senators Urso, Murray, Lawson, Tikoian, DiPalma, LaMountain, Ujifusa, | |
Date Introduced: February 05, 2025 | |
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 shall not conduct or participate in spread pricing in this |
15 | state, which means that a pharmacy benefit manager shall ensure that the total amount required to |
16 | be paid by a health benefit plan and a covered person for a prescription drug covered under the plan |
17 | does not exceed the amount paid to the pharmacy for dispensing the drug. |
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1 | 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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1 | This act would require that pharmacy benefit managers ensure that the total amount |
2 | required to be paid by a health benefit plan and a covered person for a prescription drug covered |
3 | under the plan does not exceed the amount paid to the pharmacy for dispensing the drug. |
4 | This act would take effect upon passage. |
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