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, or an epilepsy or seizure disorder. This prohibition applies under certain circumstances, such as when an enrollee has previously been prescribed the 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 is stable on a nonpreferred medication that was prescribed in an inpatient setting.

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 an amendment. It requires the Rhode Island medical assistance program to ensure that managed care organizations comply with the provisions of this section through contract amendments. The bill clarifies that medications removed from the market due to safety concerns by the FDA are not covered by this prohibition. Additionally, the bill defines "step therapy protocol" and states that the act will take effect upon passage and apply to all healthcare policies, contracts, plans, and certificates in Rhode Island on or after January 1, 2025. There are no deletions from the current law mentioned in the text provided.