The bill amends Chapters 27-18, 27-19, and 27-20 of the General Laws to prohibit health insurance contracts from requiring prior authorization or step therapy protocols for nonpreferred medications classified as anticonvulsants or antipsychotics, effective January 1, 2026. This prohibition applies to both individual and group health insurance contracts, as well as hospital or medical expense insurance policies. Specific conditions are outlined under which these medications can be prescribed without prior authorization, including instances where the enrollee has previously used the nonpreferred medication, has tried a preferred medication that was ineffective, or has experienced unacceptable side effects from a preferred medication.

The bill clarifies that while the prohibition on prior authorization and step therapy protocols is in place, clinical prior authorization edits for these medications will still apply, and exceptions cannot be denied for medications that have been removed from the market due to safety concerns. It also provides a definition for "step therapy protocol" and outlines the responsibilities of the Rhode Island medical assistance program and managed care organizations to comply with these new provisions. Overall, the bill aims to improve access to essential medications for individuals with specific health needs while ensuring safety protocols remain intact.