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RI S2468
Bill
Status
2/6/2026
Primary Sponsor
Linda Ujifusa
Click for details
AI Summary
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Insurers must grant step therapy exceptions when the required step is contraindicated, has been tried and failed, will be ineffective based on clinical history, will delay medically necessary care, or will disrupt stable treatment
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Exception requests must be decided within 72 hours (24 hours for urgent cases), with unanswered requests presumed granted; approvals remain valid for at least 12 months
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Step therapy protocols cannot require patients to fail more than one drug/therapy before coverage, and patients cannot be required to remain on a step longer than 30 calendar days
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Step therapy protocols are prohibited for treatments of serious mental illness, cancer (including metastatic and hematologic), and rare diseases with limited treatment options
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The Office of the Health Insurance Commissioner gains oversight authority to require insurer reporting on step therapy outcomes, limit protocol use, and impose fines for noncompliance
Legislative Description
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.
Insurance
Last Action
Introduced, referred to Senate Health and Human Services
2/6/2026