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.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.
Requires that any insurance contract issued, amended or renewed on or after January 1, 2025, that provides hospital, medical or surgical coverage shall provide coverage for medically necessary treatment of mental health or substance use disorders.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
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.
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.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.