The bill amends Chapter 40-21 of the General Laws regarding "Medical Assistance Prescription Drugs" by introducing a new section that prohibits the Rhode Island medical assistance program and any contracts with managed care organizations from requiring prior authorization or a step therapy protocol for the prescription of nonpreferred medications classified as anticonvulsants or antipsychotics. The bill also states that if the secretary of health and human services determines that federal authorization is necessary for implementation, the executive office of health and human services is authorized to seek such state plan amendment and may delay implementation until the authorization is granted.

Additionally, the bill mandates that the Rhode Island medical assistance program require managed care organizations to comply with these provisions through amendments to their contracts. It clarifies that the prohibition does not affect clinical prior authorization edits for prescriptions of medications classified as anticonvulsants or antipsychotics. The bill also allows the medical assistance program to deny exceptions for medications that have been removed from the market due to safety concerns from the federal Food and Drug Administration. Furthermore, it defines "step therapy protocol" as a protocol that establishes a specific sequence in which prescription medications for a specified medical condition are medically necessary for a particular enrollee and are covered under a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs. The bill will take effect upon passage and will apply to all policies, contracts, plans, and certificates executed, delivered, issued for delivery, continued, or renewed in the state on or after January 1, 2026.