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 pharmacy benefit managers (PBMs) within the definition of third-party administrators. This inclusion mandates that PBMs be regulated similarly to other third-party administrators.
The bill prohibits PBMs from participating in "spread pricing," which is defined as charging or claiming any amount in excess of the amount paid to the pharmacy for a prescription drug, less an administrative fee. This provision ensures that the total amount required to be paid by a health benefit plan and a covered person for a prescription drug covered under the plan does not exceed the amount paid to the pharmacy for dispensing the drug.
The act will take effect upon passage.
Statutes affected: 165: 27-29.1-7
165 SUB A: 27-29.1-7