Rhode Island § 27-18-50.1 § 27-18-50.1. Medication synchronization.

Rhode Island Statutes

§ 27-18-50.1 — § 27-18-50.1. Medication synchronization.

Rhode Island § 27-18-50.1

Title 27Insurance

Ch. 27-18Accident and Sickness Insurance Policies

This text of Rhode Island § 27-18-50.1 (§ 27-18-50.1. Medication synchronization.) is published on Counsel Stack Legal Research, covering Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

R.I. Gen. Laws § 27-18-50.1 (2026).

Text

§ 27-18-50.1. Medication synchronization.
(a) An individual or group health insurance plan or policy delivered, issued for delivery,
            or renewed in this state on or after January 1, 2017, providing prescription drug
            coverage in the state, must permit and apply a prorated, daily cost-sharing rate to
            covered prescriptions for a chronic condition that are dispensed by an in-network
            pharmacy for less than a thirty (30) days' supply if the prescriber and pharmacist
            determine the fill or refill to be in the best interest of the patient for the management
            or treatment of a chronic, long-term care condition and the patient requests or agrees
         

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§ 27-18-50.1. Medication synchronization.

(a) An individual or group health insurance plan or policy delivered, issued for delivery, or renewed in this state on or after January 1, 2017, providing prescription drug coverage in the state, must permit and apply a prorated, daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed by an in-network pharmacy for less than a thirty (30) days' supply if the prescriber and pharmacist determine the fill or refill to be in the best interest of the patient for the management or treatment of a chronic, long-term care condition and the patient requests or agrees to less than a thirty (30) days' supply for the purpose of synchronizing the patient's medications and the insured's or enrollee's maintenance-prescription drug(s) to be synchronized meets all of the following requirements:

(1) Is covered by the policy, certificate, or contract described in this chapter;

(2) Is used for the management and treatment of a chronic, long-term care condition and have authorized refills that remain available to the insured or enrollee;

(3) Except as otherwise provided in this subparagraph, is not a controlled substance included in schedules II to V;

(4) Meets all utilization management requirements specific to the maintenance-prescription drugs at the time of the request to synchronize the insured's or enrollee's multiple maintenance-prescription drugs;

(5) Is of a formulation that can be effectively split over required short-fill periods to achieve synchronization; and

(6) Does not have quantity limits or dose-optimization criteria or requirements that will be violated when synchronizing the insured's or enrollee's multiple maintenance-prescription drugs.

(b) The plan or policy described in subsection (a) shall apply a prorated, daily cost-sharing rate for maintenance-prescription drugs that are dispensed by an in-network pharmacy for the purpose of synchronizing the insured's or enrollee's multiple maintenance-prescription drugs.

(c) The plan or policy described in subsection (a) shall not reimburse or pay any dispensing fee that is prorated. The insurer shall only pay or reimburse a dispensing fee that is based on each maintenance-prescription drug dispensed.

(d) A synchronization shall only occur once per year per maintenance-prescription drug.