Directs the state board of pharmacy to annually identify up to fifteen prescription drugs with increased costs and provide the list to the attorney general to obtain reasons for the cost increases.
H5116 creates a new chapter in Rhode Island law on pharmaceutical cost transparency. It directs the state board of pharmacy, working with the Department of Health, to identify each year up to 15 prescription drugs that account for significant state health spending and have experienced large wholesale acquisition cost increases. The board must share that list with the attorney general, who would then require manufacturers to submit a written justification and supporting documentation explaining the price increases. The attorney general must compile an annual report to the General Assembly and post it publicly, while the underlying manufacturer submissions remain confidential.
The bill also expands state oversight of prescription drug coverage and reimbursement. It requires the insurance commissioner to adopt rules for HealthSource RI plans so that formularies are posted in a searchable, standardized format with information on covered drugs, cost-sharing, tiers, prior authorization, step therapy, and other utilization management rules. In addition, the Department of Health must use the same dispensing fee for 340B prescription drugs as for non-340B drugs under Medicaid, study how other states reimburse 340B entities, and report recommendations on any changes. The bill further creates an advisory commission to examine out-of-pocket prescription drug limits for exchange plans and to recommend plan designs and cost-sharing options for future plan years.
If enacted, the bill would add a new pharmaceutical cost transparency chapter to Title 5 and impose new reporting, disclosure, and rulemaking duties on the Board of Pharmacy, the Department of Health, the Attorney General, and the insurance commissioner. It would also create a civil enforcement mechanism allowing the attorney general to seek injunctive relief, costs, attorneys’ fees, and penalties for manufacturers that fail to provide required information. The measure would affect prescription drug manufacturers, 340B entities, Medicaid reimbursement practices, and insurers offering plans through HealthSource RI, while leaving manufacturers free to set prices as allowed under federal law.
The bill’s stated purpose and structure suggest a generally reform-oriented, consumer-protection sentiment focused on lowering health care costs through transparency and oversight. Because there are no recorded committee transcripts or votes in the provided materials, there is no direct evidence of formal support or opposition in the legislative record supplied here. The bill appears designed to appeal to lawmakers concerned about prescription drug affordability, insurer transparency, and the financial impact of drug pricing on the state and consumers.
The most likely points of contention are the bill’s mandatory disclosure requirements for drug manufacturers, the attorney general’s authority to demand pricing justifications, and the potential civil penalties for noncompliance. Another area of debate is the 340B reimbursement provision, which could affect hospitals, clinics, pharmacies, and Medicaid financing by changing dispensing fee treatment. The advisory commission on out-of-pocket prescription drug limits could also draw differing views from insurers, consumer advocates, and patient groups, especially because the bill contemplates both higher and lower cost-sharing plan designs for exchange coverage.