RI H7536

Group health insurance plans must cover pharmacist services within their lawful scope of practice and under collaborative practice agreements, effective January 1, 2027, if the same services would be covered when performed by physicians, nurse practitioners, or physician assistants

Covered pharmacist services include patient evaluation and management, medication therapy management review, immunization education and administration, medication administration, and ordering/evaluation of clinical laboratory tests

Insurers cannot require supervision, signature, or referral from another healthcare provider as a condition for reimbursing pharmacists, though insurers are not required to pay for duplicative services rendered by both a pharmacist and another provider

Health plans must include an adequate number of pharmacists in their medical provider networks; pharmacy participation in drug benefits does not satisfy this network requirement

The Executive Office of Health and Human Services must submit a Medicaid state plan amendment by September 1, 2026, and all provisions sunset on January 1, 2031, unless extended by the General Assembly