This bill amends Chapter 40-21 of the General Laws regarding "Medical Assistance Prescription Drugs" by introducing a new section that prohibits the Rhode Island medical assistance program and any contract between the Rhode Island medical assistance program and managed care organizations from requiring prior authorization or a step therapy protocol for the coverage of medications classified as anticonvulsants or antipsychotics.

The bill specifies that if the secretary of the executive office of health and human services determines that federal authorization is necessary for the implementation of this section, the secretary is authorized to seek such a state plan amendment and may delay implementation until the authorization is granted. It also mandates that the Rhode Island medical assistance program require managed care organizations to comply with these provisions through amending current and future medical assistance managed care contracts.

Additionally, the bill requires the Rhode Island medical assistance program and managed care organizations to collect and provide specific data related to the spending and utilization of anticonvulsant and antipsychotic medications from 2021 to 2029. This data includes annual gross and net amounts spent, average annual costs by class for generic and non-generic medications, total claims, adherence to preferred drug lists, prior authorization submissions, step therapy exceptions, and approval and denial percentages for prior authorizations and step therapy.

The provisions of this section will take effect on January 1, 2027, and will sunset and be repealed on December 31, 2029.