The bill amends Section 27-29.1-7 of the General Laws concerning the regulation of pharmacy benefits managers (PBMs) as part of third-party administrators. It establishes that PBMs are prohibited from reimbursing pharmacies or pharmacists for prescription drugs or pharmacy services at an amount lower than the national average drug acquisition cost plus a professional dispensing fee, or, if that information is unavailable, at an amount not less than the wholesale acquisition cost plus the professional dispensing fee.

The bill also grants the Office of the Health Insurance Commissioner (OHIC) the authority to enforce these provisions by imposing civil fines of up to $10,000 per violation and allows the Attorney General to take action against PBMs for any legal violations. Additionally, it includes a clause stating that if any provision of this section is found unconstitutional, preempted, or otherwise invalid, the remaining provisions and their application to other persons or circumstances will not be affected by that invalidity. The act is set to take effect upon passage.

Statutes affected:
5254: 27-29.1-7