Caps the total amount that a covered person is required to pay for a covered prescription inhaler, prescription device, or prescription equipment to twenty-five dollars ($25.00) per thirty (30) day supply.
Impact
The introduction of this bill would amend the existing laws on prescription drug benefits in Rhode Island. By implementing a co-pay cap specifically for respiratory medication, the bill seeks to enhance consumer protection in the health insurance market. It would prevent excessive cost-sharing and support the health and welfare of patients who rely on inhaled medications and devices to manage their conditions. The legislation is anticipated to positively impact public health by encouraging compliance with prescribed asthma treatments.
Summary
Bill S0461 aims to provide more affordable access to prescription inhalers, devices, and equipment used by individuals suffering from respiratory conditions, particularly asthma. The legislation specifically requires health plans to cap the maximum co-payment for these items at $25 per thirty-day supply. This measure is designed to alleviate the financial burden on individuals required to manage chronic respiratory illnesses, ensuring that essential medications and devices are more accessible without the hindrance of high co-pays or deductibles.
Contention
During discussions surrounding Bill S0461, notable points of contention may arise, particularly from health insurance providers who may argue that the co-pay cap could impose financial strains on their operations. Additionally, there are potential concerns about the enforcement of compliance with the new regulations, as specified diagnostic justifications for prescribed medications could lead to disputes over what constitutes a medical necessity. There is a broader dialogue regarding the balance between necessary healthcare provisions and the economic realities faced by health insurers in maintaining profitability.
Caps the total amount that a covered person is required to pay for a covered prescription asthma inhaler to twenty-five dollars ($25.00) per thirty (30) day supply.
Caps the total amount that a covered person is required to pay for a covered prescription asthma inhaler to twenty-five dollars ($25.00) per thirty (30) day supply.
Caps the total amount that a covered person is required to pay for a covered prescription asthma inhaler to twenty-five dollars ($25.00) per thirty (30) day supply.
Eliminates prior authorization or step therapy requirement for prescriptions for any HIV prevention drug/prohibits the requirement of any copayment or the meeting of any deductible to obtain the prescription covered by the contract, plan, or policy.
Eliminates prior authorization or step therapy requirement for prescriptions for any HIV prevention drug/prohibits the requirement of any copayment or the meeting of any deductible to obtain the prescription covered by the contract, plan, or policy.
Caps amount payable for 30 day supply of equipment/supplies for insulin administration/glucose monitoring at $25 or equipment designed to last more than 30 days with no deductible commencing January 1, 2025.
Caps amount payable for 30 day supply of equipment/supplies for insulin administration/glucose monitoring at $25 or equipment designed to last more than 30 days with no deductible commencing January 1, 2025.
Relating to the regulation of prescriptions for controlled substances, including certain procedures applicable to electronic prescriptions for Schedule II controlled substances.