The bill amends Chapter 27-20.8 of the General Laws by introducing a new section that establishes a co-pay cap for prescription asthma inhalers, prescription devices, and prescription equipment. It mandates that health plans providing coverage for these items must limit the out-of-pocket expense for covered individuals to no more than twenty-five dollars ($25.00) for a thirty-day supply. Furthermore, coverage for these items will not be subject to any deductibles, ensuring that patients can access necessary medications without significant upfront costs.

The bill defines "prescription inhaler" as a prescribed inhaled medication approved by the FDA for the treatment or prevention of a respiratory condition, including but not limited to pressurized metered dose inhalers (pMDI), dry powdered inhalers (DPI), and soft mist inhalers (SMI). It clarifies that "prescription devices" and "prescription equipment" refer to prescribed supplies used to administer inhaled medications, such as nebulizers and holding chambers.

Additionally, the bill allows health plans to reduce cost-sharing below the specified cap and restricts the use of prior authorization policies to confirm the presence of diagnoses or other medical conditions that demonstrate medical necessity. The Office of the Health Insurance Commissioner is granted enforcement powers to ensure compliance with this section and the authority to promulgate rules and regulations necessary for its implementation and alignment with federal requirements. This act is set to take effect on January 1, 2026.