The bill amends Chapter 40-21 of the General Laws regarding "Medical Assistance — Prescription Drugs" by introducing a new section, 40-21-4, which prohibits the Rhode Island medical assistance program and any contracts with managed care organizations from requiring prior authorization or a step therapy protocol for nonpreferred medications classified as anticonvulsants or antipsychotics. The bill also outlines that if federal authorization is needed for implementation, the executive office of health and human services can seek a state plan amendment and may delay implementation until such authorization is granted. Additionally, it mandates that managed care organizations comply with these provisions through amendments to their contracts.

The bill clarifies that clinical prior authorization edits for anticonvulsant or antipsychotic medications are not affected by this prohibition. It also allows for exceptions to be denied for medications removed from the market due to safety concerns as determined by the federal Food and Drug Administration. The definition of "step therapy protocol" is provided, and the act is set to take effect upon passage, applying to all relevant healthcare policies and contracts executed or renewed on or after January 1, 2026.