| 23 | | - | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1 |
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| 24 | | - | Policies" is hereby amended by adding thereto the following section: 2 |
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| 25 | | - | 27-18-91. Epinephrine injectors. 3 |
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| 26 | | - | (a) The Rhode Island general assembly recognizes that epinephrine cartridges and injectors 4 |
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| 27 | | - | are life-saving devices which must be administered quickly to be effective. Such administration is 5 |
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| 28 | | - | often done by persons who are not health care professionals, and is done in an emergency situation. 6 |
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| 29 | | - | Accordingly, it is in the best interests of the people of the state to promote the widespread 7 |
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| 30 | | - | availability of epinephrine cartridges and injectors. 8 |
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| 31 | | - | (b) Every individual or group health insurance contract, plan, or policy that provides 9 |
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| 32 | | - | prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state 10 |
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| 33 | | - | on or after January 1, 2025, shall provide coverage for at least one type of epinephrine auto-injectors 11 |
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| 34 | | - | and cartridges. There shall be no copayment required, and no deductible shall need to be met, to 12 |
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| 35 | | - | obtain a two (2) pack of the epinephrine auto-injectors or cartridges covered by the contract, plan, 13 |
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| 36 | | - | or policy, once every twelve (12) month plan year. A deductible may be applied to health plans that 14 |
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| 37 | | - | are paired with federally qualified health savings account pursuant to 26 U.S Code § 223. Nothing 15 |
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| 38 | | - | in this section would prohibit a health plan from implementing this benefit prior to January 1, 2025. 16 |
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| 39 | | - | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 17 |
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| 40 | | - | Corporations" is hereby amended by adding thereto the following section: 18 |
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| 41 | | - | 27-19-83. Epinephrine injectors. 19 |
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| 23 | + | SECTION 1. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits" is 1 |
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| 24 | + | hereby amended by adding thereto the following section: 2 |
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| 25 | + | 27-20.8-5. Co-pay cap for prescription epinephrine auto injectors. 3 |
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| 26 | + | (a) As used in this section, unless the context otherwise requires, "prescription epinephrine 4 |
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| 27 | + | auto injectors" or "epi-pens" means a device that delivers the drug epinephrine, that is used when 5 |
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| 28 | + | a person is experiencing a severe allergic reaction, known as anaphylaxis. 6 |
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| 29 | + | (b) A health plan that provides coverage for prescription epinephrine auto injectors, 7 |
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| 30 | + | pursuant to the terms of a health coverage plan the health plan offers, shall cap the total amount 8 |
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| 31 | + | that a covered person is required to pay for a covered prescription epinephrine auto injector at an 9 |
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| 32 | + | amount not to exceed thirty-five dollars ($35.00), per thirty (30) day supply of epinephrine auto 10 |
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| 33 | + | injectors. Coverage for prescription epinephrine auto injectors shall not be subject to any 11 |
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| 34 | + | deductible. 12 |
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| 35 | + | (c) Nothing in this section prevents a health plan from reducing a covered person's cost to 13 |
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| 36 | + | an amount less than the amount specified in subsection (b) of this section. 14 |
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| 37 | + | (d) The office of the health insurance commissioner may promulgate rules and regulations 15 |
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| 38 | + | as necessary to implement and administer this section and to align with federal requirements. 16 |
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| 39 | + | (e) The office of the health insurance commissioner may use any of its enforcement powers 17 |
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| 40 | + | to obtain a health plan's compliance with this section. 18 |
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| 44 | | - | LC001879/SUB A - Page 2 of 4 |
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| 45 | | - | (a) The Rhode Island general assembly recognizes that epinephrine cartridges and injectors 1 |
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| 46 | | - | are life-saving devices which must be administered quickly to be effective. Such administration is 2 |
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| 47 | | - | often done by persons who are not health care professionals, and is done in an emergency situation. 3 |
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| 48 | | - | Accordingly, it is in the best interests of the people of the state to promote the widespread 4 |
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| 49 | | - | availability of epinephrine cartridges and injectors. 5 |
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| 50 | | - | (b) Every individual or group health insurance contract, plan, or policy that provides 6 |
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| 51 | | - | prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state 7 |
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| 52 | | - | on or after January 1, 2025, shall provide coverage for at least one type of epinephrine auto-injectors 8 |
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| 53 | | - | and cartridges. There shall be no copayment required, and no deductible shall need to be met, to 9 |
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| 54 | | - | obtain a two (2) pack of the epinephrine auto-injectors or cartridges covered by the contract, plan, 10 |
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| 55 | | - | or policy, once every twelve (12) month plan year. A deductible may be applied to health plans that 11 |
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| 56 | | - | are paired with federally qualified health savings account pursuant to 26 U.S Code § 223. Nothing 12 |
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| 57 | | - | in this section would prohibit a health plan from implementing this benefit prior to January 1, 2025. 13 |
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| 58 | | - | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 14 |
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| 59 | | - | Corporations" is hereby amended by adding thereto the following section: 15 |
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| 60 | | - | 27-20-79. Epinephrine injectors. 16 |
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| 61 | | - | (a) The Rhode Island general assembly recognizes that epinephrine cartridges and injectors 17 |
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| 62 | | - | are life-saving devices which must be administered quickly to be effective. Such administration is 18 |
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| 63 | | - | often done by persons who are not health care professionals, and is done in an emergency situation. 19 |
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| 64 | | - | Accordingly, it is in the best interests of the people of the state to promote the widespread 20 |
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| 65 | | - | availability of epinephrine cartridges and injectors. 21 |
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| 66 | | - | (b) Every individual or group health insurance contract, plan, or policy that provides 22 |
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| 67 | | - | prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state 23 |
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| 68 | | - | on or after January 1, 2025, shall provide coverage for at least one type of epinephrine auto-injectors 24 |
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| 69 | | - | and cartridges. There shall be no copayment required, and no deductible shall need to be met, to 25 |
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| 70 | | - | obtain a two (2) pack of the epinephrine auto-injectors or cartridges covered by the contract, plan, 26 |
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| 71 | | - | or policy, once every twelve (12) month plan year. A deductible may be applied to health plans that 27 |
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| 72 | | - | are paired with federally qualified health savings account pursuant to 26 U.S Code § 223. Nothing 28 |
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| 73 | | - | in this section would prohibit a health plan from implementing this benefit prior to January 1, 2025. 29 |
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| 74 | | - | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 30 |
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| 75 | | - | Organizations" is hereby amended by adding thereto the following section: 31 |
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| 76 | | - | 27-41-96. Epinephrine injectors. 32 |
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| 77 | | - | (a) The Rhode Island general assembly recognizes that epinephrine cartridges and injectors 33 |
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| 78 | | - | are life-saving devices which must be administered quickly to be effective. Such administration is 34 |
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| 79 | | - | |
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| 80 | | - | |
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| 81 | | - | LC001879/SUB A - Page 3 of 4 |
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| 82 | | - | often done by persons who are not health care professionals, and is done in an emergency situation. 1 |
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| 83 | | - | Accordingly, it is in the best interests of the people of the state to promote the widespread 2 |
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| 84 | | - | availability of epinephrine cartridges and injectors. 3 |
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| 85 | | - | (b) Every individual or group health insurance contract, plan, or policy that provides 4 |
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| 86 | | - | prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state 5 |
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| 87 | | - | on or after January 1, 2025, shall provide coverage for at least one type of epinephrine auto-injectors 6 |
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| 88 | | - | and cartridges. There shall be no copayment required, and no deductible shall need to be met, to 7 |
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| 89 | | - | obtain a two (2) pack of the epinephrine auto-injectors or cartridges covered by the contract, plan, 8 |
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| 90 | | - | or policy, once every twelve (12) month plan year. A deductible may be applied to health plans that 9 |
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| 91 | | - | are paired with federally qualified health savings account pursuant to 26 U.S Code § 223. Nothing 10 |
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| 92 | | - | in this section would prohibit a health plan from implementing this benefit prior to January 1, 2025. 11 |
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| 93 | | - | SECTION 5. This act shall take effect upon passage. 12 |
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| 43 | + | LC001879 - Page 2 of 3 |
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| 44 | + | SECTION 2. This act shall take effect upon passage. 1 |
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