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Rhode IslandH85792026 Regular SessionHouse

AN ACT RELATING TO INSURANCE -- PHARMACY BENEFIT MANAGERS ACT .

Sponsored By: Tina L. Spears (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 0 benefits, 1 costs, 3 mixed.

Funding oversight of pharmacy benefit managers

PBM certificate holders must pay assessments that cover the regulator’s PBM oversight costs, including experts and contractors. All penalties collected under this law go into the Health Insurance Market Integrity Fund, a restricted state account.

Pharmacy benefit managers face stronger penalties

Beginning January 1, 2027, the Health Insurance Commissioner oversees PBMs and can enforce this law. Operating without a certificate can trigger restitution and damages to injured people and a civil penalty equal to the greater of $10,000 for a first violation and $15,000 for each later violation, or the total gross receipts tied to the violations. For any violation, the commissioner may order restitution and penalties on the same scale; if not paid within 20 days of mailing, the certificate can be suspended or revoked unless a court stays the order. Certificates can be suspended or revoked after notice and hearing for fraud, misrepresentation, incompetence, financial irresponsibility, misappropriation, unfair trade practices, loss of a similar license elsewhere, failure to pay state income tax, or failure to meet requirements; the office may delay action so contracts can be finished. The commissioner must issue rules to carry out the law and set how insurers, covered people, employers, and other groups are notified.

Pharmacy benefit managers must be licensed by 2027

Starting January 1, 2027, any company that manages prescription drug benefits in Rhode Island must hold a certificate from the Health Insurance Commissioner. The certificate costs $10,000 per year, lasts 24 months, and renewal is $10,000; a replacement costs $2,000. If you file to renew at least two months early, the current certificate stays active until renewal is issued or five days after a denial. Applicants must submit company papers, officer names, two years of financials, a business plan, network and pricing standards, and consumer protections, and make contracts available for review. PBMs must report major ownership or control changes right away and address changes within 30 days. They must report out‑of‑state administrative actions within 30 days and any criminal case within 30 days of the first pretrial hearing. PBMs are responsible for the actions of their subcontractors and affiliates.

Pharmacy benefit managers must reveal rebates

Every PBM must file a yearly report by July 1 that lists all price concessions, contract terms, total rebates and fees from drug makers, how much was passed to insurers and patients at the point of sale, and how much was kept. Reports must also state rebate percentages kept and other compensation tied to rebate contracts. The commissioner can require quarterly filings and written responses under oath. Late or missing reports can be fined up to $10,000 per day. By October 1, the office publishes combined, aggregated data while keeping individual filings confidential.

Sponsors & Cosponsors

Sponsor

  • Tina L. Spears

    Democratic • House

Cosponsors

  • Susan R. Donovan

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 138 • No: 0

House vote • 6/10/2026

PHARMACY BENEFIT MANAGERS ACT PASSAGE PASSAGE OF AMENDMENT

Yes: 68 • No: 0

House vote • 6/10/2026

PHARMACY BENEFIT MANAGERS ACT PASSAGE AS AMENDED

Yes: 70 • No: 0

Actions Timeline

  1. Signed by Governor — Chapter 366

    6/22/2026Governor

  2. Transmitted to Governor

    6/18/2026Governor

  3. Senate passed Sub A as amended in concurrence

    6/11/2026Senate

  4. Placed on Senate Calendar (06/11/2026)

    6/10/2026Senate

  5. House passed Sub A as amended (floor amendment)

    6/10/2026House

  6. Placed on House Calendar (06/10/2026)

    6/9/2026House

  7. Committee recommends passage of Sub A

    6/9/2026

  8. Proposed Substitute

    6/7/2026

  9. Scheduled for consideration (06/09/2026)

    6/7/2026

  10. Committee recommended measure be held for further study

    5/28/2026

  11. Scheduled for hearing and/or consideration (05/28/2026)

    5/22/2026

  12. Introduced, referred to House Health & Human Services

    5/22/2026House

Bill Text

  • H8579 - As Introduced

    5/22/2026

    HTMLPDF

  • H8579 - Substitute

    5/22/2026

    HTMLPDF

  • H8579 - Substitute As Amended

    5/22/2026

    HTMLPDF

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