Bill > S0786

This bill prohibits the Rhode Island medical assistance program and its managed care organizations from requiring prior authorization or step therapy (a protocol that mandates trying less expensive medications before approving a more specific or costly medication) for nonpreferred anticonvulsant and antipsychotic medications on their drug formulary. The bill requires these organizations to collect and report detailed data about medication spending, claims, adherence, prior authorization requests, and step therapy exceptions from 2020-2027, with a report due by July 1, 2027. The director of the department of health must also collect data on mental health emergency services across the state's municipalities. By October 1, 2027, the executive office of health and human services must provide this collected information to legislative committees. The bill has a built-in sunset provision, meaning its provisions will automatically be repealed on December 31, 2028, and it will apply to all health policies and contracts starting January 1, 2026. The legislation aims to streamline access to necessary psychiatric and neurological medications by reducing administrative barriers to prescription.

Health and Social Services

https://status.rilegislature.gov/