The bill amends several sections of the General Laws in Chapter 27-29.1, titled "Pharmacy Freedom of Choice - Fair Competition and Practices," to enhance the regulation of pharmacy benefit managers (PBMs). Key changes include the introduction of new definitions, such as "covered individual" and "spread pricing," and the clarification of the roles and responsibilities of PBMs.

The bill mandates that PBMs must perform their services with care, skill, prudence, diligence, and professionalism. It requires transparency in their financial dealings, including the obligation to disclose any conflicts of interest to insurers. All funds received by PBMs in relation to providing pharmacy benefit management services must be used according to their contracts with insurers, and PBMs are required to account annually for any pricing discounts, rebates, and other financial benefits received.

Additionally, the bill outlines specific regulations for PBMs, including prohibitions against penalizing pharmacists for disclosing medication costs to patients and requirements for a reasonable process to appeal, investigate, and resolve disputes regarding multi-source generic drug pricing. The appeals process must include provisions for timely communication and resolution of claims.

The total cost of enforcement will be borne by the pharmacy benefit managers and/or the insurers against whom the procedures are enforced. The director of the department of business regulation is authorized to promulgate rules and regulations concerning pharmacy benefit manager administrative fees and other related matters.

Finally, the bill requires an evaluation report on the impact of pharmacy benefit manager practices and operations on health insurance costs in Rhode Island, with findings and recommendations to be submitted to the General Assembly by March 31, 2027. Overall, the bill aims to improve accountability and transparency in pharmacy benefit management.