1-4-2. Definitions.

     When used in this chapter:

     (1) “Aeronautics” means transportation by aircraft, air instruction, the operation, repair, or

maintenance of aircraft, and the design, operation, repair, or maintenance of airports, landing fields,

or other air navigation facilities.

     (2) “Aircraft” means any contrivance now known or invented, used, or designed for

navigation of, or flight in, the air, except a parachute or other contrivance designed for air

navigation but used primarily as safety equipment.

     (3) “Air instruction” means the imparting of aeronautical information by any aviation

instructor or in any air school or flying club.

     (4) “Airport” means any area of land, water, or both, which is used or is made available for

the landing and take off of aircraft, and which provides facilities for the shelter, supply, and repair

of aircraft and which, as to size, design, surface, marking, equipment, and management meets the

minimum requirements established from time to time by the president and CEO.

     (5) “Air school” means any person engaged in giving, offering to give, or advertising,

representing, or holding himself or herself out as giving, with or without compensation or other

award, instruction in aeronautics — in flying, in ground subjects, or in both.

     (6) “Aviation instructor” means any individual engaged in giving, or offering to give,

instruction in aeronautics — in flying, in ground subjects, or in both — either with or without

compensation or other reward, without advertising his or her occupation, without calling his or her

facilities “air school” or any equivalent term, and without employing or using other instructors.

     (7) “Certificated aircraft” means any aircraft for which an aircraft certificate other than a

registration certificate has been issued by the government of the United States.

     (8) [Deleted by P.L. 2024, ch. 74, § 2 and P.L. 2024, ch. 110, § 2.]

     (9) “Civil aircraft” means any aircraft other than a public aircraft.

     (10) “Dealer in aircraft” or “aircraft dealer” means any person who engages in a business,

a substantial part of which consists of the manufacture, selling, or exchanging of aircraft and who

is registered as a dealer with the federal government.

     (11) [Deleted by P.L. 2024, ch. 74, § 2 and P.L. 2024, ch. 110, § 2.]

     (12) “Flying club” means any person (other than an individual) who, neither for profit nor

reward, owns, leases, or uses one or more aircraft for the purpose of instruction, pleasure, or both.

     (13) “Landing field” means any area of land, water, or both, which is used or is made

available for the landing and take off of aircraft, which may or may not provide facilities for the

shelter, supply, and repair of aircraft, and which, as to size, design, surface, marking, equipment,

and management meets the minimum requirements established from time to time by the president

and CEO.

     (14) “Military aircraft” means public aircraft operated in the service of the United States

army, air force, national guard, navy, marine corps, space force, or coast guard.

     (15) “Operate” means, with respect to aircraft, to use, cause to use, or authorize to use an

aircraft, for the purpose of engine start, movement on the ground (taxi), or air navigation including

the piloting of aircraft, with or without the right of legal control (as owner, lessee, or otherwise).

     (16) “Operator” means a person who operates or is in actual physical control of an aircraft.

     (17) “Owner” means the legal title holder or any person, firm, copartnership, association,

or corporation having the lawful possession or control of an aircraft under a written sale agreement.

     (18) “Person” means any individual, or any corporation or other association of individuals.

     (19) “Political subdivision” means any city or town or any other public corporation,

authority, or district, or any combination of two (2) or more, which is or may be authorized by law

to acquire, establish, construct, maintain, improve, and operate airports.

     (20) “President and CEO” means the president and chief executive officer of the Rhode

3-7-16.3. Class T legitimate theater license.

     (a) Legitimate theaters as defined in subsection (b) or subsection (c) may apply for a Class

T license. The license authorizes the holder of the license to keep for sale and to sell beverages at

retail in the place described in the license and to deliver those beverages for consumption on the

premises where sold at the times when scheduled events relating to art, the legitimate theater or

community artistic experiences may be held on those premises and for a period of one hour prior

to those events and one hour subsequent thereto, provided those events begin subsequent to twelve

o’clock (12:00) noon. The licensed premises may contain a bar. A Class T license authorizes

entertainment only in conformity with ordinances of the city or town where the facility is located

on the licensed premises. Class T licenses shall only be issued by the local licensing authority.

     (b) “Legitimate theaters,” for the purposes of this section, includes nonprofit, cultural

organizations and for-profit historic theaters located in the city of Newport, or the town of

Burrillville, or the town of Jamestown, with a primary purpose of providing a support system to

deliver and coordinate various arts activities for the benefit of the communities the theaters serve

or that provide live, regularly scheduled theatrical productions on a regular basis throughout the

year and all events contributing toward the goal of providing quality artistic experiences for the

community.

     (c) For purposes of this section, “legitimate theaters” shall also include facility

management corporations that are contractually authorized to manage buildings owned or under

the authority of the Rhode Island Convention Center Authority with a primary purpose of providing

a support system to deliver and coordinate various arts activities for the benefit of the communities

the corporations serve or that provide live, regularly scheduled theatrical productions on a regular

basis throughout the year and all events contributing toward the goal of providing quality artistic

experiences for the community.

3-7-19. Objection by adjoining property owners — Proximity to schools and

churches.

(70) Notwithstanding the provisions of this section, the board of licenses of the city of

Providence shall, after application, have the authority to exempt from the provisions of this section

any proposed retailer Class BV license intended to be located at 94 Carpenter Street on Plat 29, Lot

278 of the applicable city of Providence tax assessment map.

     (71) Notwithstanding the provisions of this section, the board of licenses of the city of

Providence shall, after application, have the authority to exempt from the provisions of this section

any proposed retailer Class BV license intended to be located at 1023 Broad Street, Plat 53, Lot

620 of the applicable city of Providence tax assessment map.

3-7-19. Objection by adjoining property owners — Proximity to schools and

churches.

3-7-19. Objection by adjoining property owners — Proximity to schools and

churches.

3-7-19. Objection by adjoining property owners — Proximity to schools and churches.

 3-10-5. Information supplemental to returns — Audit of books.

     (a) The tax administrator may at any time request further information from any person or

from the officers and employees of any corporation that he or shethe tax administrator may deem

necessary to verify, explain, or correct any return made in pursuance of the provisions of this

chapter, and for the like purpose, the administrator or his or hertheir authorized agent may examine

the books of account of that person or corporation during business hours.

     (b) Each Class A licensee authorized to sell intoxicating beverages at wholesale or retail in

this state shall file an annual report on or before February 1 with the division of taxation in the form

required by the tax administrator. Such report shall include, but not be limited to, total sales of

alcoholic beverages, sales tax, and excise tax collections on such sales for the immediately

preceding calendar year. Annually, on or before May 1, the tax administrator shall prepare and

submit to the chairs of the house and senate finance committees a report reflecting data from the

annual reports submitted by said licensee to the division of taxation. The tax administrator’s report

shall compile total sales of alcoholic beverages, sales tax, and excise tax collections by county.

 4-1-9. Animal fighting.

     Any person who causes or encourages the fighting of any bird, dog, or animal with any

other bird, dog, or animal, or keeps or maintains any place for the fighting of birds, dogs, or animals,

or who knowingly permits, or suffers, any fight to be had on his or herthe person’s premises or on

premises under his or herthe person’s control, or makes any bet or lays any wager of any kind

upon the result of that fight, shall be fined not exceeding one thousand dollars ($1,000) or be

imprisoned not exceeding two (2) years, or both, for the first offense, and for a second and any

subsequent offense shall be fined not less than one thousand dollars ($1,000) nor more than five

thousand dollars ($5,000) or be imprisoned not exceeding two (2) five (5) years, or both. In

addition, every person convicted of a first offense shall be required to perform twenty (20) hours

of community service. Every person convicted of a subsequent offense shall be required to perform

fifty (50) hours of community service. The community service penalty shall not be suspended or

deferred.

 4-1-26. Abandonment of animals.

     (a) If any person having possession and/or control of an animal abandons that animal on a

street, road, highway, or in a public place or on private property or from a motor vehicle, or in a

dwelling or any other building or structure without providing for the care of that animal, he or

shethe person shall be punished in the manner provided in § 4-1-2 for each such offense. If this

abandonment results in the death of the animal, the person shall be punished in the manner provided

in § 4-1-5. Abandonment means the relinquishment of all right, title, claim, or possession of the

animal with the intention of not reclaiming it or resuming its ownership or possession.

     (b) Any pound or animal shelter as defined under § 4-19-2, shall deem abandoned any

animal impounded and not redeemed by its owner within ten (10) days of impoundment if such

animal is wearing identification. Any animal impounded and not wearing identification shall be

deemed abandoned if not redeemed by its owner within five (5) days of impoundment. Any animal

deemed abandoned shall become the property of the impounding agency and may be adopted.

     (c) Any pound or animal shelter shall make a prompt and reasonable attempt to locate and

notify the owner of the impounded animal, including scanning the animal for a microchip.

     (d) It shall not be considered abandonment, and the provisions of subsection (a) of this

section and of § 4-24-8 shall not apply to any person who traps unowned feral or free roaming cats,

causes those cats to be spayed or neutered, and subsequently releases those cats, provided:

     (1) Any medical or surgical procedures performed on those cats are performed by a licensed

veterinarian; and

     (2) The cats are returned to the property where they were trapped.

4-1-44. Declawing cats prohibited.

     (a) For purposes of this section:

     (1) "Declawing" means an onychectomy or any other surgical procedure to amputate or

modify a portion of a cat's paw in order to remove the cat's claws. "Declawing" does not include

the trimming of nonviable claw husk or placing nonpermanent nail caps.

     (2) "Tendonectomy" means a procedure in which the tendons to a cat's limbs, paws, or toes

are cut or modified in order that the normal functioning of the claws is impaired.

     (3) "Therapeutic purpose" means a medically necessary procedure to address an existing

or recurring illness, infection, disease, injury, or abnormal condition in the claws, nail bed, or toe

bone, that compromises the cat's health. "Therapeutic purpose" shall not include a procedure

performed for a cosmetic or aesthetic purpose or to make the cat more convenient to keep or handle.

     (b) It is unlawful for any person to perform surgical claw removal, declawing, or a

tendonectomy on any cat or otherwise alter a cat's toes, claws, or paws to prevent or impair the

normal function of the cat's toes, claws, or paws.

     (c) This section does not apply to a procedure performed solely for a therapeutic purpose.

     (d) The prosecution of and procedure for discipline for violations of this section shall be in

accordance with §§ 5-25-9 and 5-25-15.

5-10-23. Fixed place of business.

     (a) Except as provided in this section, manicuring, esthetics, barbering and/or hairdressing

and cosmetic therapy, as defined in this chapter, shall be practiced only in a shop licensed under §

5-10-15. Nothing contained in this chapter shall be construed to prohibit the practice of barbering,

manicuring, and hairdressing and cosmetic therapy and esthetics in the same shop or place of

business.

     (b) Nothing in this section shall restrict a hairdresser licensed pursuant to this chapter,

operating in a licensed nursing service agency, from providing services to an individual who is

homebound at their home. For purposes of this section, “homebound” is defined as any person who

is considered housebound for purpose of federal Medicare eligibility.

     (c) Nothing in this section shall restrict any person licensed pursuant to this chapter from

providing services to an individual who is homebound, or has special needs or sensory-related

disorders or differences, at their home as verified by a licensed healthcare professional.

     (d) Nothing in this section shall restrict or prohibit any person licensed pursuant to this

chapter from providing services to an individual residing in any Department of Housing and Urban

Development (H.U.D.) recognized housing for the elderly in the H.U.D. recognized housing in

which the individual resides. Those services shall be provided in a separate room inspected by the

department of health. Students enrolled in programs of hairdressing, barbering and/or cosmetology

are prohibited in H.U.D. recognized housing.

     (e) Nothing in this section shall restrict or prohibit any person licensed pursuant to this

chapter from providing services to an individual outside a licensed shop as part of a special occasion

event, such as a wedding or prom, so long as those services are limited to hair styling and makeup,

and the health and sanitation standards expected of licensees in licensed shops are followed.

CHAPTER 5-14.1

THE HUMAN TRAFFICKING PREVENTION NOTICE AND TRAINING ACT

5-14.1-34. Record keeping.

     (a) Any person who operates a hotel or short-term rental property shall maintain records of

employee or operator training. Such records shall be kept on file by the operator of the hotel or

short-term rental property for the period during which the employee is employed by the

establishment or the operator manages the short-term rental property listing, and for one year after

such employment or operation ends. A hotel or short-term rental property operator shall provide

records to the department within a reasonable amount of time, but no later than ten (10) business

days, after such request is made in writing.

5-19.1-31. Administration of influenza and COVID-19 immunizations to individuals between

the ages of three (3) years and eighteen (18) years, inclusive.

     (a) Parental consent shall be required for all pharmacist-administered immunizations for

individuals under the age of eighteen (18) years.

     (b) The department of health shall require a pharmacist who is authorized to administer

influenza and COVID-19 immunizations to individuals between the ages of nine (9) three (3) years

and eighteen (18) years, inclusive, pursuant to § 5-19.1-2, to electronically report to the department

all immunizations administered within seven (7) days of administration in the format and for the

populations required by the department.

     (c)(1) The department of health shall require a pharmacist who is authorized to administer

influenza and COVID-19 immunizations to individuals between the ages of nine (9) three (3) years

and eighteen (18) years, inclusive, pursuant to § 5-19.1-2 to provide notification of a patient’s

immunization to the patient’s primary care provider, if known, within fourteen (14) days of

administration.

     (2) The department of health’s rules and regulations shall include provisions to ensure that

the administering pharmacist makemakes a good-faith effort to obtain information relating to the

identity of a patient’s primary care provider or primary care practice, for the purposes of fulfilling

the reporting requirements of subsection (c)(1) herein. If a patient does not have an existing

relationship with a primary care provider or primary care practice, the administering pharmacist

shall proceed with the reporting requirements contained in subsection (b) of this section.

5-19.1-35. Audits.

     (a) When an on-site audit of the records of a pharmacy is conducted by a carrier or its

intermediary, the audit must be conducted in accordance with the following criteria:

     (1) A finding of overpayment or underpayment must be based on the actual overpayment

or underpayment, and not a projection based on the number of patients served having a similar

diagnosis, or on the number of similar orders or refills for similar drugs, unless the projected

overpayment or denial is a part of a settlement agreed to by the pharmacy or pharmacist;

     (2) The auditor may not use extrapolation in calculating recoupments or penalties unless

required by state or federal laws or regulations;

     (3) Any audit that involves clinical judgment must be conducted by, or in consultation with,

a pharmacist; and

     (4) Each entity conducting an audit shall establish an appeal process under which a

pharmacy may appeal an unfavorable preliminary audit report to the entity.

     (b) This section does not apply to any audit, review, or investigation that is initiated based

on or involving suspected or alleged fraud, willful misrepresentation, or abuse.

     (c) Prior to an audit, the entity conducting an audit shall give the pharmacy fourteen (14)

days advance written notice of the audit and the range of prescription numbers involved in the audit.

The carrier or its intermediary may mask the last two digits of the numbers. Additionally, the

number of prescriptions shall not exceed one hundred fifty (150) prescription claims and their

applicable refills. The time allotted must be adequate to collect all samples. The examination of

signature logs shall not exceed twenty-five (25) signature logs in number.

     (d) A pharmacy has the right to execute the dispute resolution contained in their contract.

     (e)(1) A preliminary audit report must be delivered to the pharmacy or its corporate office

within sixty (60) days after the conclusion of the audit. A pharmacy must be allowed at least thirty

(30) days following receipt of the preliminary audit to provide documentation to address any

discrepancy found in the audit. A final audit report must be delivered to the pharmacy or its

corporate office within ninety (90) days after receipt of the preliminary audit report or final appeal,

whichever is later. A charge-back recoupment or other penalty may not be assessed until the appeal

process provided by the pharmacy benefits manager has been exhausted and the final report issued.

If the identified discrepancy for a single audit exceeds twenty-five thousand dollars ($25,000),

future payments in excess of that amount may be withheld pending the adjudication of an appeal.

Auditors shall only have access to previous audit reports on a particular pharmacy conducted for

the same entity.

     (2) Auditors may initiate a desk audit prior to an on-site audit unless otherwise specified in

the law.

     (3) Contracted auditors cannot be paid based on the findings within an audit.

     (4) Scanned images of all prescriptions including all scheduled controlled substances are

allowed to be used by the pharmacist for an audit. Verbally received prescriptions must be accepted

upon validation by the auditing entity and applicable for the initial desk or on-site audit.

     (5) The period covered by an audit may not exceed two (2) years.

     (6) Within five (5) business days of receiving the audit notification, pharmacies are

allowed, at a minimum, one opportunity to reschedule with the auditor if the scheduled audit

presents a scheduling conflict for the pharmacist.

     (f) Any clerical error, typographical error, scrivener’s error, or computer error regarding a

document or record required under the Medicaid program does not constitute a willful violation

and is not subject to criminal penalties without proof of intent to commit fraud.

     (g) Limitations.

     (1) Exceptions. The provisions of this chapter do not apply to an investigative audit of

pharmacy records when:

     (i) Fraud, waste, abuse, or other intentional misconduct is indicated by physical review or

review of claims data or statements; or

     (ii) Other investigative methods indicate a pharmacy is or has been engaged in criminal

wrongdoing, fraud, or other intentional or willful misrepresentation.

     (2) Frequency of audits. A pharmacy shall not be subject to more than one on-site audit in

connection with a carrier every twelve (12) months, unless there is an identified problem or fraud

or misrepresentation is suspected.

     (2)(3) Federal law. This chapter does not supersede any audit requirements established by

federal law.

     (h) Enforcement. The Rhode Island attorney general shall have the authority to enforce and

ensure compliance with this section.

5-19.1-36. Pharmacists — Contraceptives — Prescribing.

     (a) In accordance with this chapter and adopted by the state board of pharmacy, a

pharmacist may prescribe and dispense all short-term, FDA-approved hormonal contraceptives.

     (b) The state board of pharmacy shall adopt rules to establish, in consultation with the

Rhode Island medical board, the Rhode Island state board of nursing, and the Rhode Island

department of health, and in consideration of guidelines established by the American College of

Obstetricians and Gynecologists.

     (c) A pharmacist shall be required to:

     (1) Complete educational training approved by the state board of pharmacy that is related

to prescribing hormonal contraceptives. This training shall include training on counseling on all

methods of FDA-approved contraceptives, including those the pharmacist is not able to prescribe;

     (2) Provide a self-screening risk assessment tool, based on the current version of the U.S.

Medical Eligibility Criteria for Contraceptive Use developed by the federal Centers for Disease

Control and Prevention, that the patient must complete prior to the pharmacist’s prescribing the

hormonal contraceptive;

     (3) Provide the patient with a written record of the hormonal contraceptive prescribed and

dispensed and advise the patient to consult with a primary care practitioner or women’s healthcare

practitioner;

     (4) Notify the patient’s primary care provider that the pharmacist prescribed and/or

dispensed a short-term, FDA-approved hormonal contraceptive. If the patient does not have a

primary care provider, or refuses consent to notify the patient’s primary care provider, the

pharmacist shall provide the patient a list of physicians, clinics, or other healthcare providers to

contact regarding follow-up care; and

     (5) Dispense the contraceptives to the patient as soon as practicable after the pharmacist

issues the prescription.

     (d) All state and federal laws governing insurance coverage of contraceptive drugs,

devices, products, and services shall apply to contraceptives prescribed by a pharmacist under this

section; provided, however, an initial prescription issued pursuant to the provisions of this section

shall be limited to up to a three-month (3) supply.

     (e) Any individual health plan or group health plan and any health coverage through any

commercial health plan shall cover hormonal contraceptives that are prescribed and dispensed by

a pharmacist, including contraceptive counseling, if those contraceptives would otherwise be

covered if prescribed by another type of healthcare provider.

     (f) The Rhode Island state board of pharmacy should track and report on accessibility and

use, including the number and geographic locations of participating pharmacy stores; and number

of pharmacists that are eligible to prescribe.

     (g) Pharmacies should display signs in stores and on websites indicating on-site, behind-

the-counter availability of contraceptives.

5-19.1-37. Continuation of therapy prescription refill.

     (a)In the event a pharmacist receives a request for a prescription refill, and the pharmacist

is unable to readily obtain refill authorization from the prescriber, or the patient does not have a

prescriber, the pharmacist may dispense a one-time refill for continuation of therapy, up to, but no

more than one hundred (100) days of the prescribed medication provided that:

     (1) The prescription is not for a drug in ScheduleSchedules II-V appearing in chapter 28

of title 21 ("uniform controlled substances act");

     (2) The medication is essential to the maintenance of life or to the continuation of therapy

of a chronic condition;

     (3) In the pharmacist's professional judgment, the interruption of therapy might reasonably

produce undesirable health consequences or may cause physical or mental discomfort; and

     (4) The dispensing pharmacist notifies the prescriber of the dispensing within seven (7)

business days. If no current prescriber exists, the pharmacist shall document such in their internal

record keeping system.

5-19.1-38. Pharmacy technicians -- Scope of practice -- Pharmacy technician

dispensing process validation within institutional pharmacies.

     (a) In accordance with this chapter 19.1 of title 5and adopted by the state board of

pharmacy, a pharmacy technician or pharmacy intern may perform technology-assisted dispensing

process validation for medications prepared for distribution by another pharmacy technician or

intern within an institutional pharmacy.

     (b) Definitions. For purposes of this section, the following words and terms shall have the

following meanings:

     (1) “Automated storage and distribution devices” means a mechanical device that delivers

drugs other than by administration, and uses automated data processing technology to:

     (i) Provide effective storage and security of drugs contained in the device;

     (ii) Limit access to authorized individuals;

     (iii) Record the identity of all personnel who access the drugs stored within the device;

     (iv) Provide documentation of storage and removal of contents;

     (v) Provide ongoing documentation that monitors proper delivery of drugs to ensure patient

safety; and

     (vi) Comply with all relevant statutes, rules, and regulations.

     (2) “Controlled substance" means a drug or substance, or an immediate precursor of such

drug or substance, so designated under or pursuant to the provisions of chapter 28 of title 21.

     (3) “Dispensing process validation” means the physical verification that ensures the drug,

drug dosage, and drug form selected is the correct drug, drug dosage, and drug form for the purpose

for which it was selected. When applicable, dispensing process validation is subject to, and occurs

after, licensed pharmacist drug utilization review and clinical conflict resolution.

     (4) “Institutional pharmacy” means any pharmacy that is located within or off-site, and

contracted with, any hospital, clinic, or dispensary in which drugs are compounded or dispensed to

its patients or patients of another licensed in-patient healthcare facility with whom it has a contract.

     (5) “Supervision” means oversight and control by a licensed pharmacist who is responsible

for work performed by pharmacy technicians and pharmacy interns.

     (6) “Technology” means an electronic system designed to achieve accuracy in drug product

identity verification including, but not limited to, barcode scanning and radio frequency

identification (RFID).

     (c)(1) With regard to activities authorized, acting in compliance with this section, a licensed

pharmacist may delegate, and a pharmacy technician or pharmacy intern may perform under the

supervision of the pharmacist, technology-assisted dispensing process validation of medications

prepared for distribution by another pharmacy technician or pharmacy intern when such medication

will be administered to the patient by a licensed health carehealthcare professional, including:

     (i) Patient-specific medication orders;

     (ii) Automated storage and distribution devices stock;

     (iii) Repackaged medication from bulk to unit-of-use doses; and

     (iv) Emergency kits.

     (2) Acting in compliance with this section, a licensed pharmacist shall not delegate

dispensing process validation for:

     (i) Controlled substances; or

     (ii) Compounded products (whether sterile or non-sterile) unless the compounded products

have been previously verified by a licensed pharmacist (e.g., previously batched compounded

product).

     (3) In delegating activities under this section, a licensed pharmacist shall use reasonable

professional judgment and shall ensure that authorized activities do not require the exercise of

discretion or clinical judgment by the pharmacy technician or pharmacy intern.

     (d)(1) With regard to quality and control, the institutional pharmacy where activities

authorized in this section are conducted shall:

     (i) Document a pharmacy technician or pharmacy intern dispensing process validation

policy and procedure;

     (ii) Maintain an institutional pharmacy-specific training program including a record of

pharmacy technicians and/or pharmacy interns trained; and

     (iii) Maintain a continuous quality assessment system to periodically verify the accuracy

of the pharmacy technician or pharmacy intern dispensing process validation, including:

     (A) Recording any errors which reach the patient;

     (B) Recording any quality related events; and

     (C) Specific limits of acceptable quality related event levels before reassessment.

     (2) No pharmacy technician or pharmacy intern shall engage in authorized activities

without documentation of training.

     (e) The pharmacist-in-charge is responsible for ensuring that delegation of technology-

assisted dispensing process validation of medications by a licensed pharmacist under this section

does not lead to medication errors.

     (f) With regards to rules and regulations, the board of pharmacy shall make, adopt, amend,

and repeal such rules and regulations as may be deemed necessary by the board from time to time

for the proper administration and enforcement of this section. Such rules and regulations shall be

promulgated in accordance with the procedures specified in chapter 35 of title 42 ("administrative

procedures").

5-19.3-1. Short title.

     This chapter shall be known and may be cited as the "Defending Affordable Prescription

Drug Costs Act".

5-19.3-2. Definitions.

     As used in this chapter, the following terms have the following meanings:

     (13) "340B drug" means a drug that has been subject to any offer for reduced prices by a

manufacturer pursuant to 42 U.S.C. § 256b and is purchased by a covered entity as defined in 42

U.S.C. § 256b(a)(4).

     (21) "340B contract pharmacy" means a pharmacy, as defined in §5-19.1-2, that dispenses

340B drugs on behalf of a 340B-covered entity under contract.

     (32) "340B covered entity" means an entity participating or authorized to participate in the

federal 340B drug discount program, as described in 42 U.S.C. § 256b.

     (4) "Health insurer" means every nonprofit medical service corporation, hospital service

corporation, health maintenance organization, or other insurer offering or insuring health services.

     (5) "Pharmaceutical manufacturer" means any person or entity that manufactures or sells

prescription drugs, directly or through another person or entity, in this state.

     (6) "Pharmacy benefit manager" or "PBMs" means an entity doing business in the state

that contracts to administer or manage prescription-drug benefits on behalf of any carrier that

provides prescription-drug benefits to residents of this state.

5-19.3-3. Prohibition of certain discriminatory actions related to reimbursement of

340B covered entities and 340B contract pharmacies.

     (a) With respect to reimbursement to a 340B covered entity for 340B drugs, a health

insurer, pharmacy benefit manager, manufacturer, other third-party payor, or its agent shall not do

any of the following:

     (1) Establish a lower reimbursement amount to a 340B covered entity or 340B contract

pharmacy for a 340B drug than it would be paid for a non-340B drug, based solely on the drug's

340B status;

     (2) Impose fees, chargebacks, adjustments, or conditions on reimbursement to a 340B

covered entity, that differs from such terms or conditions applied to a non-340B entity, based on

340B status and participation in the federal 340B drug discount program set forth in 42 U.S.C. §

256b;

     (3) Deny or limit participation in standard or preferred pharmacy networks based on 340B

status;

     (4) Impose requirements relating to the frequency or scope of audits of inventory

management systems inconsistent with the federal 340B drug pricing program;

     (5) Require submission of claims-level data or documentation that identifies 340B drugs

as a condition of reimbursement or pricing, unless it is required by the Centers for Medicare and

Medicaid Services;

     (6) Require a 340B covered entity to reverse, resubmit, or clarify a claim after the initial

adjudication unless these actions are in the normal course of pharmacy business and not related to

340B drug pricing;

     (7) Interfere with, or limit, a 340B covered entity's choice to use a contract pharmacy for

drug distribution or dispensing;

     (8) Include any other provision in a contract between a health insurer, pharmacy benefit

manager, manufacturer, or other third-party payor and a 340B covered entity that differ from the

terms and conditions applied to entities that are not 340B covered entities, that discriminates against

the 340B covered entity or prevents or interferes with an individual's choice to receive a

prescription drug from a 340B covered entity, including the administration of such drugs in person

or via direct delivery, mail, or other form of shipment, or create a restriction or additional charge

on a patient who chooses to receive drugs from a 340B covered entity;

     (9) Place a restriction or additional charge on a patient who chooses to receive 340B drugs

from a 340B covered entity if such restriction or additional charge differs from the terms and

conditions applied where patients choose to receive drugs that are not 340B drugs from an entity

that is not a 340B covered entity or from a pharmacy that is not a 340B contract pharmacy;

     (10) Exclude any 340B covered entity from a health insurer, pharmacy benefit manager, or

other third-party payor network or refuse to contract with a 340B covered entity for reasons other

than those that apply equally to a non-340B entity;

     (11) Impose any other restrictions, requirements, practices, or policies that are not imposed

on a non-340B entity.

     (b) Nothing in this section is intended to limit a health insurer or pharmacy benefit

manager's ability to use preferred pharmacies or develop preferred networks so long as participation

is not based on an entity's status as a 340B covered entity and participation in the network is subject

to the same terms and conditions as a non-340B covered entity.

5-19.3-4. Exclusion.

     Nothing in this chapter applies to the Medicaid program as payor when Medicaid provides

reimbursement for covered outpatient drugs as defined in 42 U.S.C. § 1396r-8(k).

5-19.3-5. Prohibition on certain discriminatory actions by a pharmaceutical

manufacturer, agent, or affiliate of such manufacturer related to 340B entities.

     (a) A pharmaceutical manufacturer, agent, or affiliate of such manufacturer shall not deny,

restrict, prohibit, or otherwise interfere with, either directly or indirectly, the acquisition of a 340B

drug by, or delivery of a 340B drug to, a pharmacy that is under contract with a 340B covered entity

and is authorized under such contract to receive and dispense 340B drugs on behalf of the covered

entity unless such receipt is prohibited by the United States department of health and human

services.

     (b) A pharmaceutical manufacturer, agent, or affiliate of such manufacturer shall not

interfere with a 340B contract pharmacy that is actively contracted with a 340B covered entity.

     (c) A pharmaceutical manufacturer, agent, or affiliate of such manufacturer shall not

impose additional terms or limitations not required by federal law as a condition of 340B

participation.

5-19.3-6. Reporting and audit.

     Annually on or before April 1, each 340B covered entity participating in the federal 340B

drug pricing program established by 42 U.S.C. § 256b shall submit to the office of the governor,

the speaker of the house of representatives, the president of the senate, and auditor general a report

detailing the 340B covered entity's participation in the program during the previous calendar year,

which report shall be posted on the state auditor general's website and which shall contain at least

the following information:

     (1) The aggregated acquisition cost for all prescription drugs that the 340B covered entity

obtained through the 340B program during the previous calendar year.;

     (2) The aggregated payment amount that the 340B covered entity received for drugs, under

the 340B program and dispensed or administered to patients enrolled in commercial and Medicare

Supplemental plans.;

     (3) The aggregated payment amount that the 340B covered entity made:

     (i) To contract pharmacies to dispense drugs to its patients under the 340B program during

the previous calendar year;

     (ii) To any other outside vendor for managing, administering, or facilitating any aspect of

the 340B covered entity's drug program during the previous calendar year; and

     (iii) For all other expenses related to administering the 340B program, including staffing,

operational, and administrative expenses, during the previous calendar year.;

     (4) The names of all vendors, including split billing vendors, and contract pharmacies, with

which the 340B covered entity contracted to provide services associated with the covered entity's

340B program participation during the previous calendar year;

     (5) The number of claims for all prescription drugs the 340B covered entity obtained

through the 340B program during the previous calendar year, including the total number of claims

and the number of claims reported by commercial and Medicare Supplemental plans;

     (6) A description of the ways in which the 340B entity uses savings from its participation

in the 340B program to benefit patients and/or its community through programs, projects, and

services funded in whole or in part by savings from the 340B program;

     (7) A description of any and all material breach, change in 340B eligibility status, and/or

the U.S. Department of Health and Human Services, Health Resources and Services

Administration's ("HRSA") 340B program or manufacturer audits during the previous calendar

year;

     (8) A description of the 340B covered entity's self-audit and oversight of its participation

in the 340B program in compliance with the HRSA 340B program rules and guidance; and

     (9) Such additional information as the general assembly or auditor general may request.

5-19.3-7. Compliance and enforcement.

     The office of the state auditor general shall have the authority to:

     (1) Investigate complaints and take appropriate actions to ensure compliance with this

chapter.

     (2) Promulgate rules and regulations necessary to carry out the provisions of this chapter.

5-19.3-8. Violations.

     (a) A violation of chapter 13.1 of title 6 ("deceptive trade practices") shall occur each time

a prohibited act is committed.

     (b) The commission of any act prohibited by this chapter is considered a violation of

chapter 13.113 of title 6 ("unfair sales practices"), as may be amended from time to time, and

subject to any penalties thereunder.

5-19.3-9. Federal preemption.

     (a) Nothing in this chapter is to be construed or applied to be less restrictive than federal

law for a person or entity regulated by this chapter.

     (b) Nothing in this chapter is to be construed or applied to be in conflict with any of the

following:

     (1) Applicable federal law and related regulations.

     (2) Other laws of this state if the state law is compatible with applicable federal law.

     (c) Limited distribution of a drug required under 21 U.S.C. § 355-1 is not to be construed

as a violation of this chapter.

5-31.1-2. Board of examiners in dentistry — Members — Compensation — Funds.

     (a) There is created within the department of health the Rhode Island board of examiners

in dentistry composed of the following members:

     (1) Eight (8) licensed dentists, no more than three (3) shall be dental specialists as

recognized by the American Dental Association (ADA) and at least one of the three (3) dental

specialists shall be an oral and maxillofacial surgeon;

5-34-40. Advanced practice nurse advisory committee.

     (a) The seven-member (7) committee consists of two (2) certified nurse practitioners, two

(2) certified registered nurse anesthetists, two (2) certified clinical nurse specialists, and one

consumer. The director of health shall appoint the committee. In making appointments to the

committee, the director shall consider persons recommended by professional nurse organizations

and professional medical associations. The professional members of the committee shall be

currently engaged in practice. The consumer members shall be: (1) Knowledgeable in consumer

health concerns; (2) A resident of the state; (3) Not licensed as a healthcare practitioner; (4) Not a

parent, spouse, sibling, or child of a person licensed as a healthcare practitioner and not a student

in a professional program; (5) Not having a direct financial interest in healthcare services; and (6)

Not a member or an employee of any board of control of any public or private healthcare service.

     (b) Each member appointment shall be for three (3) years, with no. No member serving

shall be appointed to more than two (2) consecutive, three-year (3) terms, except that in making the

initial appointments, the director designates: four (4) members for a term of two (2) years; three (3)

members for a term of three (3) years; and the consumer members for three-year (3) terms. Upon

expiration of the term of office, a member shall continue to serve until a successor is appointed and

qualified.

     (c) This committee must meet not fewer than two (2) times per year. The committee has

the following functions:

     (1) To assess advanced nursing practice for the purpose of improving patient care.

     (2)(i) To review all complaints regarding advanced practice nurses and recommend any

and all disciplinary or corrective action that it deems appropriate, including revocation and

suspension of license upon proof that an advanced practice nurse has:

     (A) Aided or abetted an uncertified person to practice as an advanced practice nurse;

     (B) Become addicted to the use of liquor or controlled substances;

     (C) Negligently, willfully, or intentionally acted in a manner inconsistent with the health

and safety of persons entrusted to his or her care;

     (D) Had his or her authorization to practice as an advanced practice nurse denied, revoked,

or suspended in another state;

     (E) Engaged in the performance of medical functions beyond the scope of practice

authorized by the provisions of this chapter;

     (F) Willfully failed to file or record medical records and reports;

     (G) Mental incompetence; or

     (H) Willfully failed to maintain standards established by the nursing profession.

     (ii) The recommendation shall be submitted to the board of nursing for implementation.

     (3) To advise periodically the board of nurse registration and nursing education regarding

advanced nurse practice.

5-35.2-8. Advisory committee for opticianry.

     There is created an advisory committee for opticianry, appointed by the director, to consist

of five (5) members, who shall be residents of the state, four (4) of whom shall be licensed as

opticians under the provisions of this chapter, and shall have practiced as opticians for a period of

at least five (5) years, and one layperson who shall be from the public. The members of the advisory

committee shall be appointed for terms of three (3) years; each member may serve a maximum of

no member shall be appointed to more than two (2) full terms. Upon expiration of the term of office,

a member shall continue to serve until a successor is appointed and qualified. A majority of seats

filled shall constitute a quorum. The duties of the advisory committee for opticianry shall include

but not be limited to advising the director on all matters pertaining to the licensure and regulation

5-36.1-9. Board of licensure.

     (a) The director of the department of health, with the approval of the governor, shall appoint

a board consisting of five (5) persons, all residents of the state, to constitute a board of licensure

for naturopathy with the duties, powers, and authority as stated in this chapter, and that board shall

be composed of the following:

     (1) Two (2) members who shall be licensed physicians under chapter 37 of this title who

have been actively engaged in the practice of medicine;

     (2) One member who is a representative of the general public not employed in any health-

related field; and

     (3) Two (2) members who shall be doctors of naturopathy meeting the qualifications for

licensure under this chapter.

     (b) Members shall be appointed for terms of three (3) years each with no. No member

serving shall be appointed to more than two (2) consecutive terms. Upon expiration of the term of

office, a member shall continue to serve until a successor is appointed and qualified.

     (c) In their initial appointment, the director shall designate the members of the board of

licensure as follows: three (3) members to serve for terms of three (3) years; and two (2) members

to serve for a term of two (2) years.

     (d) The director of the department of health may remove any member of the board for

cause.

     (e) Vacancies shall be filled for the unexpired portion of any term in the same manner as

the original appointment.