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HB 8172

AN ACT RELATING TO HEALTH AND SAFETY -- PRESCRIPTION DRUG SAVINGS AND TRANSPARENCY ACT OF 2026

2026 Regular Session Introduced by Edith Ajello and 9 co-sponsors

Rhode Island would study whether centralizing Medicaid prescription drug management could save costs, improve transparency, and streamline administration.

05/05/2026 Committee recommended measure be held for further study
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Bill Summary · HB 8172

Summary of HB 8172 (Rhode Island, 2026) – Prescription Drug Savings and Transparency Act of 2026

Purpose and Intent

  • Establishes a framework to evaluate whether Rhode Island should consolidate prescription drug management within the Medicaid program.
  • Recognition that Medicaid is a major budgetary item and that drug benefits drive costs, transparency, and beneficiary access.
  • Cites experiences in other states (e.g., Connecticut, Kentucky, West Virginia, Ohio) showing potential savings and administrative benefits from consolidated prescription drug management.
  • The act aims to authorize an independent, rigorous study led by the Rhode Island Office of the Auditor General to inform future decisions.

Key Provisions

1) Creation of a New Study (Chapter 23-106)

  • Designation: “Prescription Drug Savings and Transparency Act of 2026.”
  • Lead Agency: Office of the Auditor General (AG), with authority to contract with external experts (e.g., Pharmacy Pricing and Audit Consultants) as needed to perform the study.

2) Study Scope and Comparison (23-106-2 to 23-106-3)

  • The AG must compare four potential prescription drug management structures:
    1. Current RI model: Medicaid managed care organizations with multiple PBMs and multiple preferred drug lists.
    2. Statewide single preferred drug list (PDL) model, regardless of claims processing structure (as used by Connecticut, Kentucky, West Virginia).
    3. State-contracted single Pharmacy Benefit Manager (PBM) model (direct state contracting, as in Kentucky).
    4. State-administered fee-for-service model (including through a fiscal agent or administrative services organization, as in Connecticut).
  • The study must assess fiscal impact, administrative costs, pricing transparency, rebate aggregation/retention, reimbursement methods, and oversight implications.

3) Required Information and Access (23-106-4)

  • Any private entities involved with RI Medicaid prescription drug benefits must provide timely, complete, and unredacted data when requested by the AG or its contractors.
  • Information categories include:
    • Medicaid pharmacy claims (ingredient costs, dispensing fees, admin fees, utilization, etc.).
    • Rebates, price concessions, discounts, service fees, data fees, etc.
    • Arrangements or transactions involving compensation tied to Medicaid prescription drug benefits.
    • Contracts and amendments with manufacturers, wholesalers, pharmacies, intermediaries, affiliates.
    • Formularies, PDLists, utilization management criteria, step therapy, prior authorization policies.
    • Other information necessary to evaluate fiscal/administrative impacts.
  • Data protection: information used only for the study, may be confidential or aggregated/de-identified in final reporting, with appropriate privacy protections.

4) Enforcement and Oversight (23-106-5)

  • Enforcement by the Auditor General and the Attorney General. The act does not limit other authorities.

5) Reporting Timeline (23-106-6)

  • The AG must deliver a written report with findings and recommendations (including any proposed legislation) to:
    • Speaker of the Rhode Island House
    • President of the Rhode Island Senate
    • Chairs of the House and Senate Finance Committees
  • Deadline: No later than March 31, 2027.

6) Effective Date (23-106-7)

  • Act takes effect upon passage.

Who/What Would Be Affected

  • Rhode Island Medicaid program and its prescription drug benefits.
  • Private entities involved in Medicaid prescription drug benefits (PBMs, MCOs, rebate aggregators, manufacturers, pharmacies, intermediaries, and related affiliates) would be subject to information requests and data sharing for the study.
  • State regulatory and fiscal oversight processes, with potential future decisions on consolidation based on study outcomes.

Procedural and Timeline Notes

  • Introduced February 27, 2026; referred to House Finance.
  • Scheduled for hearing/consideration around May 5, 2026 (as of action history).
  • Final study report due March 31, 2027.

Impact and Implications

  • The bill does not change current Medicaid drug benefit structures immediately; it initiates a formal, independent evaluation of consolidation options.
  • If the study finds benefits to a consolidated model, Rhode Island could pursue statutory, regulatory, procurement, or contractual changes to implement one of the alternative management structures.
  • Emphasizes transparency and robust data access to ensure evidence-based policymaking, with strong protections for confidential commercial information.

Compiled from official sources — confirm details with the bill’s official record.

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