The bill amends Section 42-14.5-2.1 of the Rhode Island Health Care Reform Act of 2004 by introducing new definitions and clarifying existing terms related to health care and social services. Key insertions include definitions for "Accountability standards," "Consumer Price Index," "Identified drug," "Unsupported price increase," and "Wholesale acquisition cost." It designates the "Executive Office of Health and Human Services (EOHHS)" as the main agency responsible for overseeing various health and human service departments. The bill also establishes a process for determining unsupported price increases for prescription drugs, relying on analyses from the Institute for Clinical and Economic Review (ICER).

Additionally, the bill creates a new section, 42-14.5-6, which imposes penalties on manufacturers of identified drugs that raise prices without justification. The penalty is set at 80% of the revenue difference between current sales and what would have been generated if the previous year's wholesale acquisition cost had been maintained, adjusted for inflation. Manufacturers with annual sales exceeding $250,000 in the state will be subject to this penalty, which will be collected annually. The bill also prohibits manufacturers from withdrawing drugs to evade penalties and requires them to notify the board of pharmacy and the attorney general 180 days in advance if they intend to do so. Violations can result in a $500,000 penalty from the attorney general, and the bill outlines an appeals process for manufacturers, requiring prepayment of penalties unless financial hardship is demonstrated. The act will take effect upon passage.