Rhode Island House Bill H8254

Rhode Island 2022 Regular Session

• Introduced: 5/13/22
• Refer: 5/13/22

Caption

Accident And Sickness Insurance Policies

Impact

The bill significantly impacts existing statutes by mandating that insurers cannot impose additional fees or coverage limitations for clinician-administered drugs from providers or pharmacies of the patient's choice. This provision intends to lower the financial burdens and increase the options available to patients, allowing them to choose providers based on personal preferences rather than being constrained by insurance policies that dictate where they can receive services.

Summary

House Bill 8254 is designed to amend Rhode Island's general laws relating to accident and sickness insurance policies, specifically targeting the issue of clinician-administered drugs. The bill stipulates that health benefit issuers and pharmacy benefit managers cannot refuse to authorize or pay for covered clinician-administered drugs when dispensed by a participating provider. This essentially aims to enhance patient choice and accessibility when it comes to obtaining prescribed medications that are typically not self-administered, such as certain outpatient drugs administered in clinical settings.

Contention

Despite the potential benefits, the legislation has drawn attention and some contention among stakeholders. Critics might argue that these changes could alter the dynamics between insurers and providers, particularly raising concerns about cost implications for insurance companies. Furthermore, the role of pharmacy benefit managers may come under scrutiny as the bill seeks to limit their ability to impose restrictions on where patients can obtain their medication. The balance between ensuring patient choice and managing costs within the healthcare system is a central debate surrounding this bill.