The proposed bill, SB 468, aims to protect Rhode Island residents from excessive prices for prescription drugs by establishing a new chapter titled "Prescription Drug Cost Protection" within Title 21 of the General Laws. This legislation recognizes that high drug prices hinder access to necessary medications and contribute to rising healthcare costs.

Key provisions of the bill include:

1. **Maximum Fair Price**: The bill establishes a "maximum fair price" for referenced drugs, which cannot be exceeded by any purchaser or health plan in the state. This price is defined as the maximum rate for a drug published by the Secretary of the United States Department of Health and Human Services.

2. **Payment Prohibition**: It is prohibited for any purchaser to buy a referenced drug or seek reimbursement for it at a cost higher than the maximum fair price during the price applicability period.

3. **ERISA Plan Opt-In**: ERISA plans may elect to participate in the provisions of this chapter, with a requirement to notify the insurance commissioner in writing by February 1 of each year.

4. **Registered Agent Requirement**: Any entity that sells, distributes, delivers, or offers for sale any drug in the state must maintain a registered agent and office within the state.

5. **Savings Utilization**: Entities subject to this chapter must calculate and utilize any savings generated from compliance with the pricing rules to reduce costs for consumers, with an emphasis on promoting health equity.

6. **Reporting Requirements**: By April 1 of each year, state entities, health plans, and participating ERISA plans must submit a report to the insurance commissioner detailing the savings achieved and how those savings were used.

7. **Enforcement and Penalties**: Each violation of this chapter is subject to a fine of $1,000, with the attorney general authorized to enforce the provisions. Manufacturers are prohibited from withdrawing referenced drugs from sale to avoid compliance with the pricing regulations, and penalties are established for non-compliance.

8. **Severability Clause**: If any provision of this chapter is determined to be invalid, the invalidity will not affect other provisions or applications of the chapter.

This act would take effect upon passage.