Bill > H7187

This bill prohibits healthcare insurers from requiring or conducting reviews for certain prescription medications used to treat alcohol or opioid use disorder, or to alleviate opioid withdrawal symptoms, starting January 1, 2027. Specifically, this applies to medications containing Methadone, Buprenorphine, or Naltrexone, and any drug approved by the U.S. Food and Drug Administration (FDA) for mitigating opioid withdrawal symptoms before that date. The bill also clarifies that insurers cannot retroactively deny coverage for services if prior approval was obtained, unless that approval was based on fraudulent or inaccurate information. For Medicaid managed care organizations, the bill mandates the use of specific medical necessity criteria set by the Rhode Island division of insurance for utilization reviews. This act will become effective immediately upon its passage.

Health and Social Services

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