Rule detail : 177481

RI LEG Specialty Drug Copayments

RI LEG enacted bill SB 0871a regarding copayment limits on specialty drugs.
Added new sections titled, specialty drugs, to each of the following chapters, RI INS 27-18-50.2; RI INS 27-19-42.1 ; RI INS 27-20-37.1 and RI INS 27-41-38.3.
Bill Provisions
Every individual or group health insurance contract or policy, that provides prescription drug coverage issued or renewed on/ after Jan. 1, 2025, shall limit any required copay.
Copayment applicable to covered specialty drugs, not to exceed one hundred fifty dollars ($150) per month for each drug up to a 30-day supply of any single drug.
Bill specified that this limit shall be applicable after any deductible is reached and until the individual's maximum out-of-pocket limit has been reached.
This does not preclude an entity, subject to this section, from reducing covered individual's cost sharing for a specialty drug to an amount less than that described.
Legislative History
On Mar. 30, 2023, bill introduced in Senate; on May 30, 2023, bill passed in Senate.
On May 31, 2023, bill introduced in the House; on Jun. 15, 2023, bill passed in House.
On Jun. 19, 2023, bill sent to the governor; on Jun. 23, 2023, bill signed by governor.
Effectiveness
Provisions of bill SB 871 (enacted as Ch 233) shall be effective on Jan. 1, 2025.

Regulators	RI LEG
Entity Types	CNSM; Ins
Reference	Ch 233, Bill SB871a, 6/23/2023; Citation: RI INS 27-18, 27-19, 27-20, 27-41;
Functions	Claims/Accelerated Benefits; Compliance; Legal; Product Administration
Countries	United States of America
Category
State
Products	Accident; Insurance; Insurance-Health
Regions	Am
Rule Type	Final
Rule Date	6/23/2023
Effective Date	1/1/2025
Rule Id	177481
Linked to	N/A
Reg. Last Update	6/23/2023
Report Section	US Insurance