Rhode Island 2023 Regular Session

Rhode Island House Bill H6159

Introduced
3/17/23  

Caption

Prescription Drug Benefits

Impact

The implementation of H6159 is set to take effect for health plans that are entered into, amended, extended, or renewed on or after January 1, 2024. This timeline provides insurers and health plan managers a window to adjust their policies in accordance with the new regulations. The bill addresses a vital area of healthcare coverage, potentially improving the financial predictability for enrollees by ensuring that third-party payments are factored into the overall cost-sharing calculations.

Summary

House Bill 6159 introduces significant amendments to the existing prescription drug benefits regulations in Rhode Island. The primary focus of the bill is to include all costs paid by an enrollee or on behalf of the enrollee by a third party when calculating their total contribution toward any out-of-pocket maximum or cost-sharing requirements under health plans. This change aims to ensure that individuals are not burdened with unforeseen costs when accessing prescription drug coverage.

Contention

Notably, the bill does not seem to have been met with significant opposition in discussions or voting history, indicating broad legislative support for its provisions. However, the inclusion of third-party payments in cost calculations may invite scrutiny regarding the financial implications for health plan providers. The adjustments could require updates in internal accounting practices for insurers and pharmacy benefit managers, which may be a point of discussion as the effective date approaches.

Companion Bills

No companion bills found.

Previously Filed As

RI S0799

Prescription Drug Benefits

RI SB1361

Prescription drugs: cost sharing: pharmacy benefit managers.

RI SB1509

Relating To Prescription Drugs.

RI H1509

Prescription Drugs

RI SB873

Prescription drugs: cost sharing.

RI SF2477

Health insurance, Medicare supplement benefits and prescription drugs provisions modifications

RI HB880

Prescription drugs; provide for reduction of patients' cost for.

RI SB45

Enacts provisions relating to payments for prescription drugs

RI SB512

Enacts provisions relating to payments for prescription drugs

RI SB134

AN ACT relating to prescription drugs.

Similar Bills

CA AB913

Pharmacy benefit managers.

CA SB362

Chain community pharmacies: quotas.

LA HB432

Provides for the regulation of pharmacy services administrative organizations (OR +$88,000 SG EX See Note)

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

LA HB387

Provides for the regulation of pharmacy services administrative organizations

CA AB401

Pharmacy: remote dispensing site pharmacy: telepharmacy: shared clinic office space.

CA AB690

Pharmacies: relocation: remote dispensing site pharmacy: pharmacy technician: qualifications.

MS HB1119

Pharmacy benefit managers; revise provisions related to.