The proposed bill, known as the "Prescription Drug Savings and Transparency Act of 2026," establishes a framework for evaluating the potential benefits of consolidating prescription drug management within Rhode Island's Medicaid program. The bill authorizes the office of the auditor general to conduct a comprehensive performance, financial, and cost-effectiveness study to assess whether such consolidation would be advantageous for the state.

The study will compare various prescription drug management structures currently implemented by other state Medicaid programs, including the administration of pharmacy benefits through managed care organizations, a single statewide preferred drug list, a single state-contracted pharmacy benefit manager, and a state-administered fee-for-service model. The auditor general is empowered to contract with independent pharmacy pricing and audit consultants or other qualified external entities to ensure a thorough analysis.

The scope of the study will include a comparison of current Medicaid prescription drug expenditures with projected expenditures under different management models, an assessment of administrative costs and pricing transparency, an analysis of impacts on beneficiary access and provider practices, and a review of cost savings and implementation challenges experienced by other states. The study will also provide recommendations for any necessary statutory, regulatory, procurement, or contract changes.

Private entities involved in Medicaid prescription drug benefits are required to provide timely, complete, and unredacted access to information and records necessary for the study, including data on pharmacy claims, rebates, and contracts. The findings and recommendations from the study must be reported to the speaker of the house of representatives, the president of the senate, and the chairs of the house and senate finance committees by March 31, 2027. The act emphasizes the importance of transparency and oversight in managing Medicaid prescription drug expenditures.