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

     

     Introduced By: Senators Urso, Murray, Lawson, Tikoian, DiPalma, LaMountain, Ujifusa,
and Ruggerio

     Date Introduced: February 05, 2025

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 27-29.1-7 of the General Laws in Chapter 27-29.1 entitled "Pharmacy

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Freedom of Choice — Fair Competition and Practices" is hereby amended to read as follows:

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     27-29.1-7. Regulation of pharmacy benefits managers.

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     (a) Pharmacy benefits managers shall be included within the definition of third-party

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administrator under chapter 20.7 of this title and shall be regulated as such. The annual report filed

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by third-party administrators with the department of business regulation shall include: contractual

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language that provides a complete description of the financial arrangements between the third-party

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administrator and each of the insurers covering benefit contracts delivered in Rhode Island; and if

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the third-party administrator is owned by or affiliated with another entity or entities, it shall include

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an organization chart and brief description that shows the relationships among all affiliates within

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a holding company or otherwise affiliated. The reporting shall be in a format required by the

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director and filed with the department as a public record as defined and regulated under chapter 2

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of title 38.

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     (b) A pharmacy benefit manager shall not conduct or participate in spread pricing in this

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state, which means that a pharmacy benefit manager shall ensure that the total amount required to

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be paid by a health benefit plan and a covered person for a prescription drug covered under the plan

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does not exceed the amount paid to the pharmacy for dispensing the drug.

 

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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 that pharmacy benefit managers ensure that the total amount

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required to be paid by a health benefit plan and a covered person for a prescription drug covered

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under the plan does not exceed the amount paid to the pharmacy for dispensing the drug.

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     This act would take effect upon passage.

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