Healthcare (Prescription Drugs)

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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passed · Rhode Island · Senate Apr 3, 2026

SB 2462: 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 PBMs, lowering drug costs and improving patient affordability - directly supports healthcare access and cost containment.95% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · House Mar 3, 2026

HB 7948: AN ACT RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

Caps the total amount that a covered person is required to pay for a covered prescription inhaler, prescription device, or prescription equipment to twenty-five dollars ($25.00) per thirty (30) day supply.

Topics ✓ HealthcareSupports HealthcareCaps patient out-of-pocket costs for prescription inhalers/devices to $25/month, directly improving affordability and access to essential healthcare services.95% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · House May 5, 2026

HB 7692: AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND HUMAN SERVICES

Sets controls on Medicaid prescription drug costs by imposing transparency and accountability requirements on managed care organizations (MCOs) and their pharmacy benefit managers (PBMs).

Topics ✓ Budget & TaxesSupports Budget & TaxesBill imposes cost controls on Medicaid drug spending to reduce state expenditure, promoting fiscal responsibility in government spending.80% confidence ✓ HealthcareSupports HealthcareImposes transparency requirements on MCOs/PBMs to control Medicaid drug costs, improving patient access and cost management.90% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · Rhode Island · House Feb 26, 2026

HB 7816: AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

HB 7816 requires pharmacy benefit managers (PBMs) in Rhode Island to provide written medical justification when denying coverage for prescription drugs. The bill mandates that denials include a detailed, clinically supported reason based on recognized medical standards, reviewed by a licensed healthcare professional, and delivered simultaneously to both the prescribing provider and the patient. It applies to all prescription drug benefit denials under insurance plans governed by Rhode Island law, without changing the terms of the insurance contracts themselves. The law takes effect on January 1, 2027.

Topics ✓ HealthcareSupports HealthcareRequires PBMs to justify prescription denials with medical rationale, enhancing patient access and transparency in insurance coverage decisions.95% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · House Jan 29, 2026

HB 7188: AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Caps amount payable for 30 day supply of equipment/supplies for insulin administration/glucose monitoring at $25 or equipment designed to last more than 30 days with no deductible commencing January 1, 2027.

Topics ✓ HealthcareSupports HealthcareCaps insulin equipment costs at $25, improving patient access to essential diabetes care and reducing financial barriers in insurance coverage.90% confidence

Sub-Topics Prescription Drugs

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died · Rhode Island · Senate Apr 14, 2026

SB 2386: AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

SB 2386 requires health insurance plans in the state to cover specific pharmacist services starting January 1, 2027. It mandates coverage for services like medication therapy management, immunizations, and medication administration - services that would be covered if provided by physicians - without requiring supervision or referrals from other providers. Insurance plans must include pharmacists in their medical provider networks (distinct from pharmacy drug benefit networks) and cover these services even outside the network when no local provider is available. The law expires on January 1, 2031, unless extended by the legislature. This directly affects insurers, pharmacists, and patients seeking these covered services.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for pharmacist services (medication therapy, immunizations) without referrals, expanding access and strengthening coverage.95% confidence

Sub-Topics Insurance Prescription Drugs

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passed · Rhode Island · Senate Jun 4, 2026

SB 2109: AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT

SB 2109 prohibits health insurers and pharmacy benefit managers from requiring or conducting insurance reviews for prescriptions used to treat opioid or alcohol use disorder. Specifically, it blocks reviews for medications containing methadone, buprenorphine, or naltrexone, or for any FDA-approved medication managing opioid withdrawal. The bill directly affects patients seeking addiction treatment and insurers/pharmacy managers handling these prescriptions. It also requires Medicaid managed care organizations to use state-set medical necessity criteria for reviews. The law takes effect upon passage.

Topics ✓ HealthcareSupports HealthcareBlocks insurer reviews for opioid/alcohol treatment meds (methadone, buprenorphine), improving patient access to essential addiction care without unnecessary barriers.95% confidence

Sub-Topics Medicaid Prescription Drugs Substance Abuse

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died · Rhode Island · Senate Apr 14, 2026

SB 2112: AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Requires health plans that provide prescription benefits to cover at least one type of glucagon auto-injector, nasal spray, or formulation that does not require reconstitution to treat hypoglycemia. No copayment or deductible would be required.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for glucagon auto-injectors without copayments, expanding access to critical hypoglycemia treatment and aligning with healthcare support indicators.95% confidence

Sub-Topics Prescription Drugs

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