House Bill #5196 (2021)

AN ACT RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

Limits health plans that provide coverage for prescription insulin drugs used to treat diabetes to forty dollars ($40.00) for a copayment for a thirty (30) day supply of medically necessary insulin. Effective date 1/1/2022.

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Changes since original draft

  • 2021 – H 5196
  • 2021 – H 5196 SUBSTITUTE A AS AMENDED
  • ========
  • LC000335
  • LC000335/SUB A
  • ========
  • S TATE OF RHODE IS LAND
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2021
  • ____________
  • A N A C T
  • RELATING TO INSURANCE – PRESCRIPTION DRUG BENEFITS
  • IntroducedBy: RepresentativesKennedy,Azzinaro, Bennett,Vella-Wilkinson, Solomon,
  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2021
  • ____________
  • A N A C T
  • RELATING TO INSURANCE – PRESCRIPTION DRUG BENEFITS
  • IntroducedBy:RepresentativesKennedy,Azzinaro,Bennett,Vella-Wilkinson,Solomon,
  • Diaz, and Morales
  • Date Introduced: January 27, 2021
  • Referred To: House Health, Education & Welfare
  • (by request)
  • It is enacted by the GeneralAssembly as follows:
  • SECTION 1. Chapter 27-20.8 of the GeneralLaws entitled "Prescription Drug Benefits"is hereby amended by adding thereto the following section:
  • It is enacted by the General Assembly as follows:
  • SECTION 1. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits" is hereby amended by adding thereto the following section:
  • 27-20.8-3. Co-pay cap for prescription insulin.
  • (a)Asusedin this section, unless thecontextotherwise requires, "prescription insulin drug" meansa prescription drug, asdefined in §21-31-2, thatcontains insulin andis usedto treatdiabetes.
  • (b) A carrier that provides coverage for prescription insulin drugs pursuant to the terms of a health coverage plan the carrier offers shallcapthe total amount thata coveredperson is required to pay for a coveredprescription insulin drug atanamount not to exceedfifty dollars ($50.00), per thirty (30) day supply of insulin, regardless of the amount or type of insulin needed to fill the covered person's prescription. Coverage for prescription insulin drugs shall not be subject to any deductible.
  • (c) Nothing in this section prevents a carrier fromreducing a coveredperson's cost sharing to an amount less than the amount specified in subsection (b) of this section.
  • (d) The health insurance commissioner mayuse any of their enforcementpowers to obtain a carrier's compliance with this section.
  • (e) The commissioner may promulgate rules as necessary to implement and administer this section and to align with federalrequirements.
  • SECTION 2. This act shalltake effect on January 1, 2022. ======== LC000335 ========
  • LC000335 - Page 2of 3
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • RELATING TO INSURANCE – PRESCRIPTION DRUG BENEFITS
  • ***
  • This actwould provide that health insurance carriers thatprovide coverage for prescription insulin drugs usedto treatdiabetes shall only be allowed to charge up to fifty ($50.00) dollars for a copayment for a thirty (30) day supply of insulin regardless of the amount or type of insulin needed to fill the covered person's prescription. Coverage for prescription insulin would not be subject to any deductible.
  • This act would take effect on January 1, 2022. ======== LC000335 ========
  • LC000335 - Page 3of 3
  • (a)Asusedinthissection,unlessthecontextotherwiserequires,"prescriptioninsulindrug" meansaprescriptiondrug,asdefinedin§21-31-2,thatcontainsinsulinandisusedtotreat diabetes.
  • (b) Ahealth planthat provides coverage for prescription insulin drugs pursuant tothe terms of a health coverage plan the health plan offers shall cap the total amount that a covered person is required to pay for a covered prescription insulin drug at an amount not to exceed forty dollars ($40.00), per thirty (30) day supply of insulin. Coverage for prescription insulin drugs shall not be subject to any deductible.
  • (c) Nothing in this section prevents a health plan from reducing a covered person's cost sharing to an amount less than the amount specified in subsection (b) of this section.
  • (d)The office of the healthinsurancecommissioner mayuse anyof itsenforcement powers to obtain a health plan's compliance with this section.
  • (e) The office of the health insurance commissioner may promulgate rules and regulations as necessary to implement and administer this section and to align with federal requirements.
  • SECTION 2. This act shall take effect on January 1, 2022. ======== LC000335/SUB A ========
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • RELATING TO INSURANCE – PRESCRIPTION DRUG BENEFITS
  • ***
  • This act would provide that health plans that provide coverage for prescription insulin drugs used to treat diabetes shall only be allowed to charge up to forty dollars ($40.00) for a copayment for a thirty (30) day supply of insulin regardless of the amount or type of insulin needed to fill the covered person's prescription. Coverage for prescription insulin would not be subject to any deductible.
  • This act would take effect on January 1, 2022. ======== LC000335/SUB A ========

Votes

NOTE: Electronic voting records are unofficial and may not be accurate. For an official vote tally, check the House or Senate Journal from the day of the vote.

Floor vote for Passage

June 29, 2021 at 3:32pm
Yeas: 37 / Nays: 0 / Not voting: 1 / Recused: 0
Legislator Vote
Sen. Acosta Y
Sen. Algiere Y
Sen. Anderson Y
Sen. Archambault Y
Sen. Bell Y
Sen. Burke Y
Sen. Calkin NV
Sen. Cano Y
Sen. Ciccone Y
Sen. Coyne Y
Sen. Cruz Y
Sen. DiMario Y
Sen. DiPalma Y
Sen. Euer Y
Sen. Felag Y
Sen. Gallo Y
Sen. Goldin Y
Sen. Goodwin Y
Sen. Kallman Y
Sen. Lawson Y
Sen. Lombardi Y
Sen. Lombardo Y
Sen. Mack Y
Sen. McCaffrey Y
Sen. Mendes Y
Sen. Miller Y
Sen. Morgan Y
Sen. Murray Y
Sen. Paolino Y
Sen. Pearson Y
Sen. Picard Y
Sen. Quezada Y
Sen. Raptakis Y
Sen. Rogers Y
Sen. Ruggerio Y
Sen. Seveney Y
Sen. Sosnowski Y
Sen. Valverde Y