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Bill > S0222


RI S0222

RI S0222
Requires pharmacy benefit managers to reimburse pharmacist no less than national drug acquisition costs plus fee.


summary

Introduced
02/10/2025
In Committee
02/10/2025
Crossed Over
Passed
Dead
06/20/2025

Introduced Session

2025 Regular Session

Bill Summary

This act would require pharmacy benefit managers to reimburse a pharmacist in an amount not less than the national average drug acquisition cost plus dispensary fee, or in circumstance in which that information is unavailable then in an amount not less than the wholesale acquisition cost plus dispensary fee. This act would take effect upon passage.

AI Summary

This bill amends Rhode Island's pharmacy benefit manager (PBM) regulations to require PBMs to reimburse pharmacists at a rate that is no less than the national average drug acquisition cost (NADAC) plus a professional dispensing fee equivalent to the current Medicaid covered outpatient prescription drug reimbursement fee. If the NADAC is unavailable, PBMs must reimburse at least the wholesale acquisition cost (WAC) plus the same professional dispensing fee. The bill defines NADAC as the monthly survey of retail pharmacy acquisition costs conducted by the federal Centers for Medicare and Medicaid Services. The Office of Health Insurance Commissioner (OHIC) is empowered to enforce these provisions by imposing civil fines up to $10,000 per violation, and the attorney general is not precluded from taking additional enforcement actions. The bill also includes a severability clause, which means that if any part of the provision is found unconstitutional or invalid, the rest of the section remains in effect. The act will take effect immediately upon passage, aiming to ensure fair compensation for pharmacists and increase transparency in drug reimbursement practices.

Committee Categories

Health and Social Services

Sponsors (10)

Last Action

Committee recommended measure be held for further study (on 03/20/2025)

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