The bill amends Chapter 40-21 of the General Laws entitled "Medical Assistance Prescription Drugs" by adding a new section that prohibits the Rhode Island medical assistance program and any managed care organization contracts from requiring prior authorization or a step therapy protocol for the prescription of nonpreferred medications used to treat certain mental health conditions and epilepsy or seizure disorders. The conditions specified include bipolar disorder, schizophrenia or schizotypal disorder, major depressive disorder, post-traumatic stress disorder as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition, and epilepsy or seizure disorders. This prohibition applies under certain circumstances, such as when an enrollee has previously been prescribed the nonpreferred medication, when preferred medications have failed to produce desired health outcomes or caused unacceptable side effects, when the enrollee has been stabilized on a nonpreferred medication, or when the enrollee has been unsuccessfully treated with a preferred medication.

The bill also outlines that if federal authorization is necessary for implementation, the executive office of health and human services is authorized to seek such amendments and may delay implementation until authorization is granted. It requires that future medical assistance managed care contracts comply with the provisions of this section. The bill clarifies that this section does not prevent the Rhode Island medical assistance program from denying an exception for a medication that has been removed from the market due to safety concerns by the FDA. Additionally, the bill defines "step therapy protocol" and states that the act will take effect upon passage and applies to all policies, contracts, and certificates executed, delivered, issued for delivery, continued, or renewed in the state on or after January 1, 2025.