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SB 2563

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

2026 Regular Session Introduced by Jonathon Acosta and 9 co-sponsors

Rhode Island will study whether consolidating Medicaid prescription drug management could reduce costs and improve transparency and access.

05/22/2026 Referred to House Finance
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Bill Summary · SB 2563

Bill Summary: SB 2563 (Prescription Drug Savings and Transparency Act of 2026) – Rhode Island

Purpose and overarching goals

  • Establishes the Prescription Drug Savings and Transparency Act of 2026.
  • Authorizes an independent, comprehensive study by the Rhode Island Office of the Auditor General to evaluate whether Rhode Island would benefit from consolidating prescription drug management within the Medicaid program.
  • The study aims to inform potential reforms intended to reduce costs, improve transparency, and enhance beneficiary access to medically necessary medications.

Key provisions and changes

  • Creation of a new Chapter 23-106 in the Rhode Island General Laws (Chapter 106: Prescription Drug Savings and Transparency Act of 2026).
  • Study authority and scope (23-106-2 to 23-106-3):
    • The Auditor General may contract with an independent pharmacy pricing and audit consultant (PPAC) or other qualified external entities to conduct the evaluation.
    • The study must compare multiple prescription drug management structures, including: 1) Rhode Island’s current approach: Medicaid managed care organizations with multiple PBMs and multiple preferred drug lists. 2) A single statewide preferred drug list, regardless of administrative structure (as seen in Connecticut, Kentucky, West Virginia). 3) A single state-contracted PBM (direct state contracting, as in Kentucky). 4) A state-administered fee-for-service model (e.g., Connecticut).
  • Scope of analysis (23-106-3):
    • Compare current and projected expenditures under the various models, including fiscal impacts.
    • Assess administrative costs, pricing transparency, rebate aggregation/retention, reimbursement methodologies, and oversight implications.
    • Analyze impacts on Medicaid beneficiary access, provider prescribing practices, utilization management, and continuity of care.
    • Review experiences of other states, including cost savings, health outcomes, and implementation challenges.
    • Provide recommendations for statutory, regulatory, procurement, or contract changes if a consolidation model is deemed beneficial.
  • Access to information (23-106-4):
    • Requires private entities involved in Medicaid prescription drug benefits (PBMs, MCOs, group purchasing organizations, rebate aggregators, etc.) to provide timely, complete, and unredacted access to information, data, and records for the study upon request by the Auditor General or contractors.
    • Categories of information include:
    • All Medicaid pharmacy claims and related costs.
    • All rebates, price concessions, discounts, administrative charges, and other remuneration.
    • Any arrangements or transactions that affect compensation related to Medicaid prescription drug benefits.
    • All contracts and amendments related to Medicaid prescription drug benefits.
    • Formularies, preferred drug lists, utilization management criteria, step-therapy protocols, and prior authorization policies.
    • Any other information necessary to evaluate fiscal, administrative, and operational impacts.
    • Data provided must be used solely for the study, protected from public disclosure per law (with confidentiality for proprietary information where allowed), and subject to privacy protections.
  • Enforcement and authority (23-106-5):
    • Enforcement by the Auditor General and the Attorney General; act does not limit existing authority.
  • Reporting timeline (23-106-6):
    • The Auditor General must deliver a written report of findings and recommendations, including proposed legislation, to the Speaker of the House, Senate President, and chairs of the House and Senate Finance Committees no later than March 31, 2027.
  • Effective date (23-106-7):
    • Takes effect upon passage.

Who would be affected

  • Medicaid pharmaceutical benefit landscape in Rhode Island:
    • Private entities involved in Medicaid prescription drug benefits (PBMs, MCOs, rebates aggregators, wholesalers, pharmacies, etc.) would be subject to data sharing for the study.
    • State agencies overseeing Medicaid administration would be examined for potential reform pathways.
  • Beneficiaries and providers:
    • Potential impacts on drug access, formulary design, prior authorization, and utilization management depend on the study’s conclusions and any subsequent legislative or regulatory changes.
  • Taxpayer and state budget considerations:
    • The study aims to inform potential cost savings, rebates retention, and administrative efficiency, which could influence Medicaid costs and state budget planning.

Procedural and timeline aspects

  • Legislative path:
    • Introduced February 13, 2026; referred to Senate Health & Human Services.
    • Schedule indicates committee activity and potential floor consideration in May 2026.
  • Study timeline:
    • Final report due by March 31, 2027.
  • Immediate effect:
    • The act takes effect upon passage, enabling the Auditor General to initiate the study and require data access from private entities as part of the evaluation.

Notes for readers

  • The bill does not itself implement a consolidation reform but paves the way for an evidence-based decision by commissioning a comprehensive statewide evaluation of different prescription drug management models within Medicaid.
  • Findings could lead to future legislative or regulatory changes regarding how Rhode Island administers Medicaid prescription drug benefits.

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

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