[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6628260,"mediaKeyId","2718453-17278db3ce17455ab564ebc4b6ff1fa9","parentId",2718453,"title","Senate health panel holds multiple PBM reform bills targeting spread pricing and reimbursement transparency","audioSeconds",711,"startMs",585000,"endMs",1296000,"viewUrl","/Search/View?dp=1&key=2718453-17278db3ce17455ab564ebc4b6ff1fa9&start=585&end=1296","thumbnailUrl","https://assets.pipeline.soar.com/2718453-17278db3ce17455ab564ebc4b6ff1fa9/thumbnail_585000.jpg","articleUrl","/articles/6628260/Rhode-Island/Senate-health-panel-holds-multiple-PBM-reform-bills-targeting-spread-pricing-and-reimbursement-transparency","mediaUrl","https://secure.pipeline.soar.com/6628260-626fecc272a26ab91b8e8934712d754e/orig.mp4?Expires=1770595094&Signature=Y9T9p2aBx~EJEeFmM9-3VDEDH1ki86kEMDfeYnCR7dHh6vgfBM0lSQl4LJm5lx2qqYRmidKVXjrAURUmhUDbBzAYrVZXYYHU67OhFSxhzJ9oYIq4B-NL5aw2qDPBjw5LDpMnBX3G25eKp2DHoInPdiw9oDIiyA3BgRcNNBnu43wUHABv4dq5VPhQSjMdBmFeA7BxI40FSlFaVzpyu-MlahTZ5AR8Vg1wQ8~mDgDVvXQ4cNks~Ms7~VABGCkgVMSK2cLhfl2WO~HSTsK8FmWpdmXNukklUwZ4cHs5BSORAMzpYrO3C6AdU1OtpTjY1Qj0~SpTPa6ynQkbVApiRIE20g__&Key-Pair-Id=KUT5TJCACFTXG","author","State of Rhode Island","date","2025-03-20T00:00:00Z","article","PROVIDENCE, R.I. — The Senate Committee on Health and Human Services on March 20 heard testimony and held a package of bills aimed at pharmacy benefit managers, or PBMs, with members saying reform is needed to protect Medicaid, commercial plan sponsors and independent pharmacies.

Senators took the first procedural action on a set of measures including Senate Bill 117 and Senate Bill 173 (both addressing Medicaid PBM practices), Senate Bill 165 (a straight prohibition on spread pricing), and Senate Bill 221 (an omnibus commercial PBM bill that would require more disclosure and consider NADAC-like pricing for commercial plans). All of the bills were formally “held” for further study by voice vote at the end of the hearing.

Supporters — including sponsor Senator Ujifusa and the Rhode Island Black, Latino, Indigenous and AAPI caucus — described PBMs as intermediary firms that take money from plans or taxpayers and pay pharmacies and providers. “PBMs are middlemen for middlemen,” said Senator Ujifusa, arguing that spread pricing and rebate-driven formularies can divert savings away from patients and providers. Independent pharmacists and health centers told the committee those practices are contributing to pharmacy closures and reduced services.

Independent pharmacists gave detailed operational testimony. Matt (Matt’s Local Pharmacy) told the committee, “I am literally hemorrhaging money out of my business… we are gonna go out of business,” describing daily losses on high-cost branded prescriptions and difficulty negotiating with PBMs such as Prime Therapeutics and Blue Cross–affiliated arrangements. Zahan Akbar (Abbott Pharmacy) and Hassan Iqbal (Park Square Pharmacy) said audit practices, tight reimbursement and central-fill models are forcing independents to cut services such as home delivery and blister packaging.

Public health and provider witnesses described attendant impacts. Matt Roman, chief operating officer at Thundermist Health Center, said the organization lost $5,600,000 in 2024 because of manufacturer and PBM restrictions tied to the 340B program and related spread-pricing dynamics, forcing program cuts and layoffs. Elena Nicolella, representing Rhode Island’s eight community health centers, told the committee those health centers serve more than 210,000 Rhode Islanders and have lost “over $16,000,000 since 2022” because of changing contract pharmacy access and manufacturer limits.

Pharmaceutical industry representatives urged caution and called for broader approaches. Rachel Caudill Latham of PhRMA said state-level price controls or narrow remedies could cause unintended consequences, and suggested the committee consider the entire supply chain and market dynamics. Brian Jordan, a pharma contract lobbyist, and other industry witnesses said the system is complex and includes insurers, PBMs and pharmacies.

Several witnesses and senators described legislative options already used in other states, including banning spread pricing, mandating pass-through pricing or NADAC/NADEF-based reimbursement, and requiring PBMs to disclose rebates and fees. Supporters pointed to states such as Ohio, Texas and Kentucky as examples where PBM regulation yielded Medicaid savings and stronger reimbursement to pharmacies.

Committee action: Senate Bill 117 — motion to hold made by Senator Lauria, seconded by Senator Thompson; committee voice vote, bill held. Senate Bill 173 — motion to hold made by Senator Thompson, seconded by Senator Apollonio; committee voice vote, bill held. Senate Bill 165 — motion to hold made by Senator Loria, seconded by Senator Erso; committee voice vote, bill held. Senate Bill 221 — motion to hold made by Senator Arloyer (mover) and Senator Sewell (second); committee voice vote, bill held.

What remains: Committee members asked for data and documentation that proponents and opponents cited in testimony, including information about the dollar amount and mechanisms of spread pricing, the structure of PBM audits, and evidence about reform impacts used by other states. Senator Jafusa asked industry representatives to provide documentation supporting claims that spread pricing increases costs by specific percentages.

The committee did not adopt final policy and left the bills “held” for additional review and possible amendment. Supporters said they will continue to press for reforms focused on transparency, reimbursement tied to NADEF/NADAC pricing or outright bans on spread pricing; opponents cautioned about unintended supply or access impacts and urged multi‑stakeholder solutions.","mediaType","Video","parentTitle","Senate Committee on Health & Human Services: 3-20-2025","oneSentenceSummary","PROVIDENCE, R.I. — The Senate Committee on Health and Human Services on March 20 heard testimony and held a package of bills aimed at pharmacy benefit managers, or PBMs, with members saying reform is needed to protect Medicaid, commercial plan sponsors and independent pharmacies.","taxTitle","2025 Legislature RI, Rhode Island","taxId",77689,"location","Rhode Island","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6628257,"Hospitals, health centers and pharmacists clash over 340B contract pharmacy protections as Senate panel reopens bill",1418,1502000,2920000,"/Search/View?dp=1&key=2718453-17278db3ce17455ab564ebc4b6ff1fa9&start=1502&end=2920","https://assets.pipeline.soar.com/2718453-17278db3ce17455ab564ebc4b6ff1fa9/thumbnail_1502000.jpg","/articles/6628257/Rhode-Island/Hospitals-health-centers-and-pharmacists-clash-over-340B-contract-pharmacy-protections-as-Senate-panel-reopens-bill","https://secure.pipeline.soar.com/6628257-f4790f1b3b085904ce5b64a70a045a07/orig.mp4?Expires=1770595094&Signature=iICKcnQiedpyDNl2J3VuHqalEPUUJD2VhPDFkbyRVSFe63~E9VsMcsnRXE~F4JWzaUbxRf5W-iYPwSuAAE1REZb0DIEvPQlbaWdFR2My880Ypk2lIJ6rPbaR8DsNek7tnG9LD~ayhcMoVSOoA~b-K7tDqWmG~p5Xlf2nV6WIU~5sP1u7uv1qYkyInBtXkN1XxehcQET8MC1nlY4-8Nc6TJBF4SJXnccaoR6dlVhrmi4Q3-DpLASNefUCfUHfMTiwtoOgAEnraXb5zZOvS9h8bsp6GMBHCU1evicQkRGSzn2cGfDi9xF5GewmrerCE9jR05obG3XnwsmVMKgZOlI2HQ__&Key-Pair-Id=KUT5TJCACFTXG","PROVIDENCE, R.I. — Senate Bill 114, proposing to bar pharmaceutical manufacturers, PBMs or insurers from discriminating against 340B covered entities by restricting contract pharmacy access, returned to the Senate Committee on Health and Human Services on March 20 for additional testimony.

Senator Valverde, sponsor of SB 114, told the committee the federal 340B program was designed to let safety‑net hospitals and community health centers purchase medicines at discounted prices and use the savings to expand services for vulnerable patients. Community health center representatives, hospitals and specialty pharmacy managers described large revenue losses and program barriers when manufacturers restricted the contract pharmacies that covered entities could use.

Elena Nicolella, speaking for Rhode Island’s eight community health centers, said the centers serve more than 210,000 residents and “the decision of the pharmaceutical manufacturers to limit the number of contract pharmacies ... has caused the health centers to lose over $16,000,000 since 2022.” Matt Roman of Thundermist Health Center said the organization lost $5,600,000 in 2024 alone and attributed layoffs, elimination of a community health worker program and reduced feeding programs to that revenue loss.

Care New England’s Carolyn Sundberg, a licensed pharmacist, gave patient examples of how 340B savings funded free or reduced‑price medications and expanded on‑site services. “The 340B program has been vital in enabling us to stretch every dollar further,” she told the committee, citing charity care, patient assistance programs, behavioral health services and an on‑site pharmacy expansion.

Pharmaceutical industry witnesses opposed the bill. Rachel Caudill Latham of PhRMA said the program “has strayed far from its intended purpose” and warned that codifying universal contract‑pharmacy access could entrench a network of for‑profit actors monetizing the program and undermine accountability. She also said 340B is an entity‑ or site‑based program not tied to patient income, and urged careful study before changing the state law.

The hospital association, represented by Matt Roman (speaking on behalf of hospitals earlier in the hearing) and others, argued the hospitals that qualify as 340B entities serve disproportionate numbers of government‑insured and uninsured patients; they described community benefits paid for using 340B savings and cited services that include cancer treatment, diabetes education, opioid treatment, mental health services and food pantries.

Committee action: Senators voted to table SB 114 earlier in the hearing (motion made by Senator Vallejo, seconded by Senator Loria; committee voice vote to table). Later in the session the committee removed SB 114 from the table and then voted to hold it for further consideration (removal motion made by Senator Russo, seconded by Senator Ujifusa; subsequent motion to hold made by Senator Erso and seconded). The bill remains under active committee review.

Why it matters: Witnesses for safety‑net providers said contract‑pharmacy restrictions have directly reduced funds that cover charity care and community programs; industry witnesses said the program requires better federal transparency and that actions by manufacturers reflected attempts to curb program misuse. The committee asked both sides for documentation and asked state staff to track the fiscal and access implications before further action.","PROVIDENCE, R.I. — Senate Bill 114, proposing to bar pharmaceutical manufacturers, PBMs or insurers from discriminating against 340B covered entities by restricting contract pharmacy access, returned to the Senate Committee on Health and Human Services on March 20 for additional testimony.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6628251,"Committee advances bill letting pharmacists substitute therapeutically equivalent drugs to reduce delays",599,5547000,6146000,"/Search/View?dp=1&key=2718453-17278db3ce17455ab564ebc4b6ff1fa9&start=5547&end=6146","https://assets.pipeline.soar.com/2718453-17278db3ce17455ab564ebc4b6ff1fa9/thumbnail_5547000.jpg","/articles/6628251/Rhode-Island/Committee-advances-bill-letting-pharmacists-substitute-therapeutically-equivalent-drugs-to-reduce-delays","https://secure.pipeline.soar.com/6628251-a1abc0506e08ff5b690398a7c083c67e/orig.mp4?Expires=1770595094&Signature=hBiqhhwstCVuKzQo7QGgRJYBx03z~sIUaL5MdS8GkRWVoDOwYjxl4k6sjA~NlhPm10jqPEDzJ0bDDr0Vaq0vpPjj9k8ck7urUXJry61CZt2InPWzjbmasNqpe8moLlxnZjqorLVC03zeEcddGZA17GQ9c8uxK7-4njXUmRFJGqzZl5jPkMS3kImd5qcsgRWWbmSUDTgWV6O8iRCAflTTy~spxpJEAAxplMcmNnFLYzCSK2PDS4XL~LMadQXYjxfR9ilY0mQBSYiAtIVMXxllZScW2LPNUmCAvuPXWC57QCDDF-vSXnsI4UQckWToCHWwf2mBmdPRpE5Y7Ezjpx~8ww__&Key-Pair-Id=KUT5TJCACFTXG","PROVIDENCE, R.I. — The Senate Committee on Health and Human Services considered Senate Bill 482 on March 20, a measure that would explicitly permit pharmacists to substitute therapeutically equivalent drugs and therapeutically equivalent devices or supplies at the point of dispensing.

Sponsor Senator Lauria told the committee the change would allow pharmacists to make clinically appropriate interchanges — for example, switching among proton pump inhibitors or selecting a therapeutically equivalent inhaler — without delaying therapy while waiting for the prescriber to reissue a prescription. “This would allow the pharmacist to make that therapeutic equivalent change,” Lauria said, adding that the Department of Health would produce a list of therapeutically equivalent products and that safeguards could exclude non‑equivalent devices such as different types of continuous glucose monitors.

Pharmacists and pharmacy students testified in favor. Chris Federico of the Rhode Island Pharmacists Association said the bill is an update to existing substitution law and would reduce care delays caused by insurance coverage, stock shortages or formulary differences. Madison Hartling, a Pharm.D. candidate with community pharmacy experience, described a case in which formulary coverage and timing of provider signatures delayed a patient’s medication by several days; she said the ability to substitute a therapeutically equivalent product would have provided faster access.

Committee action: Senators voted to hold Senate Bill 482 after testimony; lawmakers requested collaboration between the Department of Health, the medical society and pharmacy associations on lists of therapeutically equivalent products and on guardrails to preserve patient safety.

Why it matters: Witnesses said therapeutic substitution would reduce missed or delayed treatment, particularly in urgent or out‑of‑office scenarios (weekends, holidays, vacations) and would reduce administrative burden on provider offices and pharmacies. Opponents were not recorded in testimony on this bill during the hearing.

Next steps: The committee asked for technical language and stakeholder input on the Department of Health’s list and a process for clinical consultation; the measure was held for amendment.","Senate Bill 482 would expand pharmacists’ authority to substitute therapeutically equivalent products (not just generic equivalents). Sponsors and pharmacists said the change reduces delays and prevents treatment interruptions; committee held the bill for revision after testimony.","actionData","errors"]

Article not found

Senate health panel holds multiple PBM reform bills targeting spread pricing and reimbursement transparency

Hospitals, health centers and pharmacists clash over 340B contract pharmacy protections as Senate panel reopens bill

Committee advances bill letting pharmacists substitute therapeutically equivalent drugs to reduce delays