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RI H7947
Bill
Status
2/27/2026
Primary Sponsor
Jenni Azanero Furtado
Click for details
AI Summary
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Requires insurers and pharmacy benefit managers to count third-party payments (such as copay assistance programs) toward an enrollee's out-of-pocket maximum and cost sharing requirements
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Applies to prescription drugs without a generic equivalent, or drugs with a generic equivalent when the enrollee obtained access through prior authorization, step therapy, or the plan's exceptions and appeals process
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Adds new definitions to Rhode Island insurance law for "cost sharing," "insurer," "person," and "pharmacy benefit manager"
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Includes an exception for Health Savings Account-qualified High Deductible Health Plans to maintain federal HSA eligibility under 26 U.S.C. § 223
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Takes effect for health plans entered into, amended, extended, or renewed on or after January 1, 2027
Legislative Description
Includes any costs paid by an enrollee or on behalf of the enrollee by a third party when calculating an enrollee’s overall contribution to any out-of-pocket maximum or cost sharing requirement under a health plan as of January 1, 2027.
Insurance
Last Action
Introduced, referred to House Health & Human Services
2/27/2026