The bill amends Section 27-29.1-7 of the General Laws in Chapter 27-29.1, titled "Pharmacy Freedom of Choice — Fair Competition and Practices," to include new regulations for pharmacy benefits managers (PBMs). The bill specifies that PBMs will be classified as third-party administrators and subject to the same regulations. It mandates that the annual report filed by third-party administrators with the department of business regulation must include a complete description of financial arrangements with insurers and an organizational chart if the administrator is affiliated with other entities. This report is to be filed as a public record.

Additionally, the bill sets a minimum reimbursement rate for pharmacies and pharmacists, stating that PBMs cannot reimburse them less than the national average drug acquisition cost plus a professional dispensing fee equivalent to the current Medicaid dispensing fee for Rhode Island. If the national average cost is unavailable, reimbursement must not be less than the wholesale acquisition cost of the drug plus the dispensing fee. The bill also empowers the office of the health insurance commissioner to enforce these provisions with civil fines up to $10,000 per violation or other legal actions, and it allows the attorney general to enforce laws against PBMs. The bill includes a severability clause, ensuring that if any part of the section is found invalid, the rest remains effective. The act would take effect upon passage and aims to protect independent pharmacies from discrimination by PBMs and to safeguard consumer choice for local pharmacies.

Statutes affected:
7720: 27-29.1-7