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SB 3060

AN ACT RELATING TO INSURANCE -- PHARMACY BENEFIT MANAGERS ACT

2026 Regular Session Introduced by Pete Appollonio and 5 co-sponsors

Rhode Island requires PBMs to obtain a state certificate, report pricing and rebates annually, and comply with oversight, penalties, and potential reforms to increase transparency

06/22/2026 Signed by Governor
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WeVote Research Nonpartisan
Bill Summary · SB 3060

Summary of SB 3060 (Rhode Island, 2026) – Pharmacy Benefit Managers Act

Purpose and intent

  • Establishes a comprehensive regulatory framework for Pharmacy Benefit Managers (PBMs) operating in Rhode Island.
  • Requires PBMs to obtain a state certificate of authority and subject PBMs to ongoing supervision, reporting, and potential penalties for noncompliance.
  • Aims to increase transparency around PBM practices, rebates, pricing, network arrangements, and consumer protections.

Key provisions and changes

  • New chapter creation

    • Adds Chapter 84 to Title 27 (Insurance), creating the Pharmacy Benefit Managers Act.

  • Definitions (27-84-2)

    • Clarifies terms such as controlling person, director (Director of the Department of Business Regulation), insured/covered individual, insurer, PBM, and rebate contracts.
    • Broadly defines PBM services to include procurement, mail order operations, claims processing, formulary management, rebates and incentives, patient adherence/therapeutic programs, disease management, prior authorizations, network contracting, and cost control.

  • Certificate of authority required (27-84-3)

    • PBMs must hold a valid certificate of authority issued by the Director of the Department of Business Regulation to operate or hold themselves out as PBMs.
    • Violations trigger restitution/compensatory damages and penalties (up to $10,000 for first violation; up to $15,000 for subsequent violations or related to aggregate gross receipts).

  • Registration and application requirements (27-84-4)

    • Detailed application process to the Director, including:
    • Organizational documents, bylaws, and governance details.
    • Identification of responsible individuals (board members, officers, controlling persons, etc.).
    • Financial statements for the last two years.
    • Business plan describing staffing and Rhode Island activities.
    • Proof of licenses if soliciting insurance contracts, and required standards for pricing, network development, consumer protection, and anti-competitive practices.
    • Disclosure of relationships and practices in other states and potential conflicts of interest.
    • Obligation to provide copies of all contracts with insurers and other clients for director inspection.
    • Duty to report material ownership/control changes and keep current address on file.

  • Certificate term, renewal, and fees (27-84-5)

    • Initial filing fee: $10,000 per year (or fraction).
    • Certificate validity: 24 months; renewal also $10,000 for a 24-month period.
    • Renewal effectiveness if renewal is filed timely; director may issue delays or refuse renewal with notice.
    • Director may deny issuanceif applicant or key individuals lack trustworthiness or competence or have prior compliance issues.
    • Director may require examinations and can issue replacements for lost certificates ($2,000 fee).

  • Reporting requirements (27-84-6)

    • Annual reporting due by July 1:
    • Disclosure of pricing, rebates, inflationary payments, clawbacks, fees, incentives, and other financial interactions.
    • Contract terms with insurers or third-party administrators, including dispensing fees and reimbursement terms.
    • Aggregate rebates and how much was passed through vs retained.
    • Details of each rebate contract (parties, dates, drug lists and codes, formulary terms, volume incentives, rebates by drug, and total prescriptions dispensed with rebates).
    • Rebate percentages and amounts retained by the PBM; other manufacturer compensation for services under each contract.
    • Optional/possible quarterly reporting as determined by the Director.
    • Authority for the Director to request additional inquiries and for PBMs to respond under oath if required.
    • Confidentiality of submitted information, with public disclosure only as determined by the Director (not applying to information controlled by others).

  • Additional obligations (27-84-7)

    • PBMs must refrain from practices prohibited for insurers.
    • PBMs must comply with state laws applicable to PBMs.
    • Responsibility for actions of subcontractors or affiliates performing PBM services.

  • Grounds for suspension or revocation (27-84-8)

    • Grounds include violations of law, misrepresentation, dishonesty, incompetence, untrustworthiness, financial irresponsibility, misappropriation, bad contract terms, insurance unfair practices, or revocation in other jurisdictions.
    • Notice and hearing required; possible postponement to meet contractual obligations.
    • Revocation has probationary/non-entitlement implications for a period (minimum one year) for individuals or entities tied to the PBM.

  • Penalties (27-84-9)

    • In addition to other penalties, the Director can order restitution and a civil penalty (up to the greater of $10,000 per offense or $15,000 per subsequent offense, or aggregated receipts).

  • Fund allocation (27-84-10)

    • Penalties deposited into the Health Insurance Market Integrity Fund (restricted account).

  • Applicability and regulatory alignment (27-84-11 to 27-84-13)

    • PBMs remain subject to other applicable laws and regulations.
    • PBMs will be assessed to cover Department operating expenses attributable to regulating PBMs.
    • The Director is authorized to promulgate regulations to implement the chapter, including notices to insurers, covered individuals, employers, and other relevant parties.

Who is affected

  • Primary: Pharmacy Benefit Managers (existing and new) operating in Rhode Island.
  • Insurers, third-party administrators, network pharmacies, covered individuals (patients), and employers that engage in PBM services.
  • The Rhode Island Department of Business Regulation (and its Director) with oversight, reporting, and enforcement responsibilities.

Procedural and timeline aspects

  • Effective date: Upon passage.
  • Certification process: PBMs must apply and obtain authority before operating; ongoing renewals every 24 months with associated fees.
  • Reporting cadence: Annual July 1 reporting; potential additional filings as required by the Director.
  • Enforcement: Hearings for suspensions/revocations; penalties and restitution for violations; confidentiality provisions for information disclosed to the Director.

Potential impact

  • Increased transparency in PBM contracts, rebates, and formulary practices.
  • Greater state-level oversight of PBMs’ impact on drug pricing and patient access.
  • New compliance, reporting, and licensing costs for PBMs.
  • Potential for improved consumer protections and reduced anti-competitive or unfair PBM practices through enhanced oversight and penalties.

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

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