The bill amends Section 27-29.1-7 of the General Laws in Chapter 27-29.1, titled "Pharmacy — Freedom of Choice Fair Competition and Practices," to regulate pharmacy benefits managers (PBMs) as third-party administrators. It requires PBMs to include in their annual reports to the Department of Business Regulation a complete description of their financial arrangements with insurers and an organizational chart if they are owned by or affiliated with other entities. This information must be filed as a public record.

Additionally, the bill stipulates that PBMs cannot reimburse pharmacies or pharmacists for prescription drugs or services at a rate lower than the national average drug acquisition cost plus a professional dispensing fee equivalent to the current Medicaid dispensing fee for Rhode Island. If the national average cost is unavailable, reimbursement must not be less than the wholesale acquisition cost plus the dispensing fee. The bill also empowers the Office of the Health Insurance Commissioner to enforce these provisions with civil fines up to $10,000 per violation and allows the attorney general to take action against PBMs. The bill includes a severability clause, ensuring that if any part of the section is found invalid, the rest remains effective. The act would take effect upon passage.

Statutes affected:
7720: 27-29.1-7