Rhode Island 2025 Regular Session

Rhode Island House Bill H5627

Introduced
2/26/25  

Caption

Requires health insurance providers to provide insurance coverage for pharmacists’ services.

Impact

The bill proposes significant changes to state laws regarding health insurance, allowing pharmacists greater autonomy and recognition in patient care. By ensuring that services rendered by pharmacists are treated equivalently to those provided by physicians and nurses, H5627 will facilitate broader access to healthcare, particularly in primary care management and medication therapy. This legislative change is expected to reduce the load on traditional healthcare providers and enhance patient outcomes through more integrated care.

Summary

House Bill H5627 mandates that all health insurance providers in Rhode Island must include coverage for pharmacists' services as part of their health plans, effective January 1, 2026. This act aims to enhance the role of pharmacists within the healthcare system by recognizing the various clinical services they provide, including patient evaluation, medication therapy management, immunization administration, and other related healthcare responsibilities. The inclusion of pharmacists as covered providers is intended to improve patient access to necessary medical services, especially in underserved areas.

Contention

While the bill is largely seen as a positive step towards improving healthcare delivery, some concerns have been raised regarding the implications for reimbursement structures within health insurance plans. Critics argue that the requirement for health insurance plans to cover pharmacist services may lead to increased costs and complexities in payer-provider relationships. Additionally, the stipulation that reimbursement should not depend on other healthcare provider supervision raises questions about the scope of practice and accountability among pharmacists, which could lead to debates over standards and regulations in the medical field.

Companion Bills

No companion bills found.

Previously Filed As

RI H5628

Mandates all health insurance contracts, plans, or policies provide the same reimbursement to independent healthcare facilities as that of hospital affiliated facilities where the same healthcare service is provided.

RI S0051

Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.

RI H5082

Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.

RI H6158

Mandates insurance coverage for scalp cooling treatments for breast cancer patients undergoing chemotherapy to prevent hair loss during chemotherapy treatments.

RI H6118

Requires coverage for acute mental health crisis mobile response and stabilization services to eligible individuals enrolled as plan beneficiaries.

RI S0263

Requires coverage for acute mental health crisis mobile response and stabilization services to eligible individuals enrolled as plan beneficiaries.

RI S0115

Requires health plans that provide prescription benefits to cover at least one type of glucagon auto-injector, nasal spray, or formulation that does not require reconstitution to treat hypoglycemia. No copayment or deductible would be required.

RI H5173

Requires health plans that provide prescription benefits to cover at least one type of glucagon auto-injector, nasal spray, or formulation that does not require reconstitution to treat hypoglycemia. No copayment or deductible would be required.

Similar Bills

RI S0897

Requires health insurance providers to provide insurance coverage for pharmacists’ services.

RI H5854

Adds new sections that set forth conditions for pharmacists to prescribe tobacco cessation drug therapies, including education approved by state board of pharmacy. The cessation therapies to be covered by all health insurance carriers on or after 1/1/26.

RI S0685

Adds new sections that set forth conditions for pharmacists to prescribe tobacco cessation drug therapies, including education approved by state board of pharmacy. The cessation therapies to be covered by all health insurance carriers on or after 1/1/26.

SC H3575

Pharmacy insurance benefits cost-sharing

SC S0099

Enhancement of penalties on assault crimes

HI SB1245

Relating To Pharmacists.

AR SB103

To Create The Pharmacy Nondiscrimination Act; To Require Pharmacy Benefits Managers To Accept Any Pharmacy Or Pharmacist Willing To Accept Relevant And Reasonable Terms Of Participation; And To Declare An Emergency.

NC S357

Pharmacists/Collaborative Practice