Provides for fair pharmacy reimbursement from a pharmacy benefit manager, and also provides anti-discrimination prohibitions in regard to non-affiliated pharmacies or pharmacists.

Plain-English Summary

This Rhode Island bill sets rules about how pharmacy benefit managers (PBMs) — the companies that manage prescription drug benefits for insurance plans — must treat and pay independent and non-affiliated pharmacies. PBMs act as middlemen between insurance companies, employers, and pharmacies, and they have significant control over how much pharmacies get paid when they fill prescriptions. This bill aims to ensure that pharmacies receive fair and reasonable reimbursement for the drugs they dispense.

Specifically, the bill would prevent PBMs from paying non-affiliated pharmacies (meaning pharmacies that aren't owned by or partnered with the PBM) less than what the PBM pays its own preferred or affiliated pharmacies for the same medications. It also includes anti-discrimination protections, meaning a PBM could not treat an independent or non-affiliated pharmacy worse than its own network pharmacies when it comes to reimbursement rates, terms, or other business practices.

This bill would most directly affect independent and community pharmacies, which often struggle to compete with large pharmacy chains that have closer relationships with PBMs. It could also affect patients, particularly those in rural or underserved areas who may rely on local independent pharmacies, by helping keep those pharmacies financially viable and open for business.

The bill was recently introduced and referred to the Senate Health and Human Services Committee, where it has been scheduled for a hearing but recommended to be held for further study, meaning it has not yet advanced through the legislative process.