Shown verbatim: the complete text as captured from the official PDF posted by the Rhode Island General Assembly, fetched 2026-07-29. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
S2109 2026 -- S 2109 ======== LC003217 ======== STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2026 ____________ A N A C T RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT Introduced By: Senators Urso, DiMario, Kallman, Murray, Acosta, Rogers, Gu, and Britto Date Introduced: January 16, 2026 Referred To: Senate Health & Human Services It is enacted by the General Assembly as follows: 1 SECTION 1. Chapter 27-18.9 of the General Laws entitled Benefit Determination and 2 Utilization Review Act is hereby amended by adding thereto the following section: 3 27-18.9-17. Utilization review decisions for the treatment of alcohol or substance use 4 disorder. 5 (a) For health benefit plans issued or renewed on or after the effective date of this section, 6 an insurer or pharmacy benefit manager shall not require or conduct a prospective or concurrent 7 review for a prescription medicine: 8 (1) That is used in the treatment of alcohol or opioid use disorder and contains methadone, 9 buprenorphine or naltrexone; or 10 (2) That is used in the treatment of alcohol or opioid use disorder and has been approved 11 by the United States Food and Drug Administration for the management of alcohol or opioid use 12 disorder, or the mitigation of opioid withdrawal symptoms. 13 SECTION 2. Chapter 40-8 of the General Laws entitled Medical Assistance is hereby 14 amended by adding thereto the following section: 15 40-8-33. Utilization reviews for Medicaid benefits. 16 In conducting utilization reviews for Medicaid benefits, each Medicaid managed care 17 organization shall use the medical necessity criteria selected by the executive office of health and 18 human services for making determinations of medical necessity and clinical appropriateness 1 pursuant to the utilization review plan. 2 SECTION 3. This act shall take effect upon passage. ======== LC003217 ======== LC003217 - Page 2 of 3 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT *** 1 This act would prohibit healthcare insurers or pharmacy benefit managers from requiring 2 or conducting a review for prescription medicine that is used in the treatment of alcohol or opioid 3 use disorder, that contains methadone, burenorphine, or naltrexone or that was approved for the 4 mitigation of opioid withdrawal symptoms. 5 This act would take effect upon passage. ======== LC003217 ======== LC003217 - Page 3 of 3
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