This bill aims to enhance the transparency and accountability of pharmacy benefit managers (PBMs) in Rhode Island's Medicaid program, ultimately protecting both the state's residents and the Medicaid program from high prescription drug costs. It amends Section 42-7.2-5 of the General Laws, detailing the duties of the secretary of the executive office of health and human services (EOHHS). The bill introduces new responsibilities for the secretary, including ensuring that managed care organizations (MCOs) and PBMs do not impose unnecessary costs on the Medicaid program and patients. It mandates that contracts with MCOs require PBMs to cease and prohibit activities that result in spread pricing, a payment model in which PBMs charge a health plan more than they reimburse the pharmacy for a prescription drug and retain the difference.

The act is set to take effect upon passage.

Statutes affected:
173: 42-7.2-5