Rhode Island Senate Bill S2069

Rhode Island 2022 Regular Session

• Introduced: 1/25/22
• Refer: 1/25/22

Caption

Pharmacies

Impact

If S2069 is enacted, it would enhance the regulation over PBMs in Rhode Island by requiring them to update their MAC lists routinely and provide transparency in drug pricing. The bill mandates that PBMs must inform pharmacies of updates to the MAC lists within a specified time frame and establish an administrative appeals process for pharmacies to challenge decisions regarding drug pricing. This could potentially strengthen pharmacy operations by ensuring equitable pricing structures and fostering competitive practices.

Summary

S2069, introduced by Senator Joshua Miller, aims to amend state laws relating to pharmacies and pharmacy benefits management in Rhode Island. The bill stipulates the establishment of maximum allowable cost (MAC) lists, which would set limits on how much a pharmacy benefits manager (PBM) can reimburse pharmacists for prescription drugs. The intention behind this amendment is to ensure that the prices set by PBMs are fair and reflect current market conditions, thereby avoiding situations where pharmacies are reimbursed less than their acquisition costs.

Contention

One notable point of contention regarding S2069 relates to the implications of the maximum allowable cost lists and the administrative process for contesting prices set by PBMs. Supporters argue that these regulations would protect pharmacies from unfair reimbursement practices, thus encouraging a more equitable market. Conversely, opponents may express concerns that stringent regulations might place additional administrative burdens on PBMs, potentially affecting their ability to manage costs effectively and serve patients efficiently.