Healthcare (Prescription Drugs)

died · Rhode Island · House Mar 24, 2026

HB 7947: AN ACT RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

Includes any costs paid by an enrollee or on behalf of the enrollee by a third party when calculating an enrollee’s overall contribution to any out-of-pocket maximum or cost sharing requirement under a health plan as of January 1, 2027.

Topics ✓ HealthcareSupports HealthcareBill ensures third-party payments count toward out-of-pocket maximums, reducing patient costs and improving prescription drug affordability under insurance plans.95% confidence

Sub-Topics Insurance Prescription Drugs

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died · Rhode Island · House May 5, 2026

HB 7825: AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND HUMAN SERVICES

Requires the secretary of the executive office of health and human services to monitor and mandate changes to the price-setting practices of pharmacy benefit managers to prohibit the spread pricing payment model.

Topics ✓ HealthcareSupports HealthcareProhibits spread pricing by pharmacy benefit managers, aiming to lower drug costs and improve patient affordability in healthcare services.90% confidence

Sub-Topics Prescription Drugs

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in committee · Rhode Island · House Feb 26, 2026

HB 7814: AN ACT RELATING TO FOOD AND DRUGS -- PRESCRIPTION BENEFIT MANAGER ACCOUNTABILITY ACT

Requires prescription benefit managers to approve a specific medication prescribed by a doctor when supported by a notarized medical necessity letter and requires that any denial be reviewed and documented by a licensed medical expert.

Topics ✓ HealthcareSupports HealthcareRequires PBMs to approve doctor-prescribed meds with medical necessity documentation and mandates expert review of denials, directly improving patient access to medications and protecting prescribing rights.95% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · House Apr 13, 2026

HB 7744: AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Amends the law on drug coverage to require insurance plans that provide coverage for prescription drugs to offer two options for prescription delivery.

Topics ✓ HealthcareSupports HealthcareMandates two prescription delivery options for insurance plans, improving patient access to medications under coverage requirements.95% confidence

Sub-Topics Prescription Drugs

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in committee · Rhode Island · House Feb 26, 2026

HB 7817: AN ACT RELATING TO INSURANCE -- PHARMACY FREEDOM OF CHOICE -- FAIR COMPETITION AND PRACTICES

Prohibits pharmacy benefits managers from refusing to provide coverage for a prescription drug chosen for a patient by the patient’s healthcare provider.

Topics ✓ HealthcareSupports HealthcareProhibits PBMs from denying coverage for provider-chosen drugs, directly enhancing patient access to prescribed medications and protecting patient rights in insurance coverage.90% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · Senate Apr 7, 2026

SB 2464: AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE RHODE ISLAND HEALTH CARE REFORM ACT OF 2004 -- HEALTH INSURANCE OVERSIGHT

SB 2464 requires Rhode Island's health insurance commissioner to produce annual reports on insurer practices, including fee schedules, provider credentialing processes, and data disclosure methods for healthcare facilities. The bill mandates that a professional-provider-health-plan work group (part of an advisory council) compile specific data to help consumers compare quality and costs of care. These reports, due by January 1, 2027, will cover topics like insurance dispute resolution, real-time enrollment verification, and the impact of "silent PPOs" on providers. The legislation directly affects health insurers, medical providers, and consumers by increasing transparency in health insurance operations and pricing.

Topics ✓ HealthcareSupports HealthcareMandates insurer transparency reports and consumer data tools to improve care comparison and oversight, advancing patient access and rights through accountability measures.95% confidence

Sub-Topics Insurance Medical Licensing Prescription Drugs

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died · Rhode Island · Senate Mar 26, 2026

SB 2466: AN ACT RELATING TO INSURANCE -- PHARMACY FREEDOM OF CHOICE -- FAIR COMPETITION AND PRACTICES

Provides for fair pharmacy reimbursement from a pharmacy benefit manager, and also provides anti-discrimination prohibitions in regard to non-affiliated pharmacies or pharmacists.

Topics ✓ HealthcareSupports HealthcareFair reimbursement for pharmacies and anti-discrimination protections improve access to medication services and promote competition in pharmacy care, aligning with healthcare access indicators.85% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · House Mar 24, 2026

HB 7950: AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE RHODE ISLAND HEALTH CARE REFORM ACT OF 2004 -- HEALTH INSURANCE OVERSIGHT

HB 7950 regulates prescription drug price increases in Rhode Island by imposing a penalty on manufacturers who raise prices without new clinical evidence. It targets "identified drugs" with "unsupported price increases" as determined by the Institute for Clinical and Economic Review (ICER). Manufacturers face an 80% penalty on the revenue difference between actual sales and what they would have earned at the prior year's wholesale cost (adjusted for inflation), but only if their annual sales exceed $250,000 in the state. The penalty applies for two years after a drug appears on ICER's annual report of unsupported increases. This directly affects drug manufacturers selling in Rhode Island who implement such price hikes.

Topics ✓ HealthcareSupports HealthcareRegulates drug price increases without clinical evidence, imposing penalties to improve affordability and patient access to medications, aligning with healthcare access protection.90% confidence

Sub-Topics Insurance Prescription Drugs

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died · Rhode Island · House Mar 24, 2026

HB 7539: AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT

Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.

Topics ✓ HealthcareSupports HealthcareLimits insurer step therapy restrictions, enabling provider exceptions for patient access to necessary medications, aligning with improved patient access indicators.95% confidence

Sub-Topics Insurance Prescription Drugs

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died · Rhode Island · House Mar 3, 2026

HB 7534: AN ACT RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACIES

HB 7534 allows licensed pharmacists to prescribe and dispense FDA-approved tobacco cessation drugs under specific conditions. Pharmacists must complete state-approved education, verify patients meet criteria (age 18+, participation in a structured program, and nicotine safety education), and refer high-risk cases to primary care providers. The bill also mandates that health insurance plans cover these pharmacist-provided cessation services starting January 1, 2027, without requiring supervision or referrals from other providers. This policy directly affects pharmacists, patients seeking smoking cessation support, and health insurers by expanding access to tobacco cessation care through pharmacists' existing scope of practice.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for pharmacist-provided tobacco cessation services, expanding access to healthcare and aligning with public health goals.95% confidence

Sub-Topics Healthcare Workforce Insurance Prescription Drugs

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