§ 27-29.1-1. Definitions. For purposes of this chapter, the following terms shall mean: (1) “Director” shall mean the director of the department of business regulation. (2) “Eligible bidder” shall mean a retail pharmacy, community pharmacy or pharmacy department registered pursuant to chapter 19 of title 5, irrespective of corporate structure or number of locations at […]
§ 27-29.1-10. Costs of enforcement. The total cost of the enforcement of §§ 27-29.1-3 and 27-29.1-8 shall be borne by the pharmacy benefits manager(s) and/or the insurer(s) against whom the complaint is made on an equal basis and shall include the following expenses: (1) One hundred fifty percent (150%) of the total salaries and benefits […]
§ 27-29.1-11. Evaluation report. The health insurance commissioner, pursuant to § 42-14.5-1, shall evaluate the impact of nonrestricted pharmacy networks on health insurance costs in Rhode Island and shall submit report of findings to the joint legislative committee on health care oversight on or before May 1, 2005. History of Section.P.L. 2004, ch. 363, § […]
§ 27-29.1-2. Requirement for availability and accessibility of pharmacy services. In accordance with § 23-17.13-3, an insurer must demonstrate to the director of health the willingness and potential ability to assure that pharmacy services will be provided in a manner to assure both availability and accessibility of adequate personnel and facilities and in a manner […]
§ 27-29.1-3. Fair competition — Requirements for carriers offering pharmacy networks. (a) An insurer that offers insureds a restricted pharmacy network shall, in soliciting, arranging, competitively bidding, contracting for, and operating such a network, comply with the following requirements for the purpose of promoting fair and competitive bidding, regardless of when the restricted pharmacy network […]
§ 27-29.1-4. Mandate to offer a nonrestricted pharmacy network. Every health care insurer that delivers or issues for delivery or renews in this state a contract, plan, or policy that provides coverage for pharmaceuticals delivered on an outpatient basis through a restricted pharmacy network, shall: (a) Also offer insurance purchasers an optional benefit plan that […]
§ 27-29.1-5. Participation of independent community pharmacies. (a) Any pharmacies licensed in the state of Rhode Island that are not owned or controlled, directly or indirectly by an entity that owns pharmacies licensed in two (2) or more jurisdictions other than Rhode Island, which are not participating in an insurer’s restricted pharmacy network contract shall […]
§ 27-29.1-6. Applicability and allowances. (a) Nothing in this section shall preclude an insurer from entering into an agreement to allow non-network providers, other than independent community pharmacies, the ability to participate with the insurer’s plans under terms and conditions set forth by the insurer. (b) The provisions of this chapter shall not apply to […]
§ 27-29.1-7. Regulation of pharmacy benefits managers. Pharmacy benefits managers shall be included within the definition of third-party administrator under chapter 20.7 of this title and shall be regulated as such. The annual report filed by third-party administrators with the department of business regulation shall include: contractual language that provides a complete description of the […]
§ 27-29.1-8. Enforcement. The department of business regulation shall have authority to enforce the provisions of §§ 27-29.1-3 — 27-29.1-7, subject to the provisions of chapter 35 of title 42. History of Section.P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
§ 27-29.1-9. Severability. If any provision of §§ 27-29.1-1 — 27-29.1-8, or the application of those sections to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of §§ 27-29.1-1 — 27-29.1-8 which can be given effect without the invalid provision or application; to this end the provisions […]
