RI S3059

Pharmacy benefit managers (PBMs) must perform services with care, skill, prudence, and diligence, and maintain duties of good faith and fair dealing with covered individuals and pharmacies

PBMs are prohibited from substituting prescription drugs without prescriber approval, charging copayments exceeding pharmacy costs, or penalizing pharmacists for disclosing medication costs and alternatives to patients

All funds received by PBMs, including spread pricing revenue, must be held in trust and used only pursuant to insurer contracts; PBMs must annually account to insurers for all rebates, discounts, fees, and other financial benefits received

PBMs must disclose in writing to insurers all contract terms with pharmacies, dispensing fees, and any conflicts of interest relating to their pharmacy benefit management services

Health insurance commissioner must evaluate PBM practices and operations impact on Rhode Island health insurance costs and submit findings and recommendations to the general assembly by March 31, 2027