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 performance, financial, and cost-effectiveness study to assess whether Rhode Island would benefit from such a consolidation. The study will compare various prescription drug management structures currently implemented by other state Medicaid programs, including those in Connecticut, Kentucky, and West Virginia.

The evaluation will focus on several key areas, including administrative costs, pricing transparency, rebate aggregation, pharmacy reimbursement methodologies, and the impact on Medicaid beneficiary access and continuity of care. The auditor general is empowered to contract with independent pharmacy pricing and audit consultants or other qualified external entities to ensure a comprehensive analysis.

Private entities involved in Medicaid prescription drug benefits are required to provide timely, complete, and unredacted access to information and data necessary for the study, including records related to 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.