The bill seeks to amend existing laws by adding provisions that restrict health insurers from requiring prior authorization or step therapy protocols for nonpreferred anticonvulsant or antipsychotic medications under certain conditions. These conditions include instances where the patient has previously been prescribed the nonpreferred medication, has not achieved the desired health outcomes with a preferred medication, has suffered unacceptable side effects from a preferred medication, has been stabilized on a nonpreferred medication and changing medications would be medically inadvisable, has not been successfully treated with a preferred medication, or is stable on a nonpreferred medication following inpatient care. The bill also includes a definition of "step therapy protocol" and clarifies that the prohibition does not affect clinical prior authorization edits or the denial of exceptions for medications that have been removed from the market for safety reasons by the FDA.

The legislation applies to individual or group health insurance contracts, policies, plans, or group policies that are delivered, issued for delivery, or renewed within Rhode Island. It also requires the Rhode Island medical assistance program and managed care organizations to adhere to these provisions, pending necessary federal authorization. The act is intended to take effect upon passage and will be applicable to all relevant policies and contracts in the state starting January 1, 2025.