Rhode Island § 40-21-1 - Medical Assistance — Prescription Drugs

§ 40-21-1. Prescription drug program.

The department of human services is hereby authorized and directed to amend its practices, procedures, regulations, and the Rhode Island state plan for medical assistance (Medicaid) pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., to modify the prescription drug program:

(1) To establish a preferred drug list (PDL);

(2) To enter into supplemental rebate, discount, or other agreements with pharmaceutical companies;

(3) To negotiate either state-specific supplemental rebates or to participate in a multistate pooling, supplemental-rebate program.

Determinations of drugs included on the PDL will be made by the State Department of Human Services, and a listing of the drugs shall be maintained on a public website. In making these determinations, the department shall consider the recommendations of the Medicaid Pharmaceutical and Therapeutics Committee, whose membership shall include practicing pharmacists and physicians, faculty members of the University of Rhode Island’s College of Pharmacy, and consumers or consumer representatives. Drugs exempt from the PDL shall include: (i) Anti-retrovirals; and (ii) Organ transplant medications. Physicians will be informed about prior authorization procedures for medications not on the PDL, and seventy-two-hour (72) emergency supplies may be dispensed if authorizations cannot be obtained; and

(4) To mandate the dispensing of generic-only drugs with the exception of limited-brand drug coverage for certain therapeutic classes as approved by the Department of Human Services to individuals eligible for medical assistance (Medicaid) under §§ 40-8.4-4, 42-12.3-4 and 42-12.3-15.