AN ACT RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS (Caps the total amount that a covered person is required to pay for a covered prescription inhaler, prescription device, or prescription equipment to twenty-five dollars ($25.00) per thirty (30) day supply.)

S2876

2026 -- S 2876
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LC005579
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

Introduced By:
Senators Murray, Thompson, Appollonio, Britto, Lauria, Ujifusa, and
Valverde

Date Introduced:
March 04, 2026

Referred To:
Senate Health & Human Services
It is enacted by the General Assembly as follows:
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SECTION 1. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits" is
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hereby amended by adding thereto the following section:
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27-20.8-5. Co-pay cap for prescription asthma inhalers, devices, and equipment.

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(a) As used in this section, unless the context otherwise requires, "prescription inhaler”
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means a prescribed inhaled medication approved by the FDA for the treatment or prevention of a
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respiratory condition, and includes, but is not limited to, pressurized metered dose inhalers (pMDI),
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dry powdered inhalers (DPI), and soft mist inhalers (SMI). "Prescription inhaler" does not include
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inhaled medications available over-the-counter without a prescription.
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(b) As used in this section, unless the context otherwise requires, "prescription devices”
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and “prescription equipment” means prescribed supplies used to administer inhaled medications,
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including, but not limited to, nebulizers and holding chambers.
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(c) A health plan that provides coverage for prescription inhalers and prescription devices
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or prescription equipment used to administer prescribed inhaled medications, pursuant to the terms
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of a health coverage plan the health plan offers, shall cap the total amount that a covered person is
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required to pay for a covered prescription inhaler, prescription device or prescription equipment
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used to administer such medications, at an amount not to exceed twenty-five dollars ($25.00), per
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thirty (30) day supply. Coverage for prescription inhalers, prescription devices or prescription
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equipment used to administer such medications, shall not be subject to any deductible.
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(d) Nothing in this section prevents a health plan from reducing a covered person's cost

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sharing to an amount less than the amount specified in subsection (c) of this section.
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(e) Prior authorization policies shall only be used to confirm the presence of diagnoses or
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other medical conditions, which demonstrates that an item or service is medically necessary.
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(f) The office of the health insurance commissioner may use any of its enforcement powers
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to obtain a health plan's compliance with this section.
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(g) The office of the health insurance commissioner may promulgate rules and regulations
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as necessary to implement and administer this section and to align with federal requirements.
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SECTION 2. This act shall take effect on January 1, 2027.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS
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This act would cap the total amount that a covered person is required to pay for a covered
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prescription inhaler, prescription device, or prescription equipment to twenty-five dollars ($25.00)
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per thirty (30) day supply.
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This act would take effect on January 1, 2027.
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LC005579
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LC005579 - Page 3 of 3