RI General Assembly passes legislation requiring health insurers to provide 30-day notice prior to making changes to plan formularies
November 16, 2016
The Rhode Island General Assembly passed legislation that requires health insurers to provide their members and prescribers at least thirty (30) days notice prior to making changes to its plan formulary. The Senate bill (S.2294) sponsored by Sen. Elizabeth A. Crowley (D-District 16, Central Falls & Pawtucket) became law after being signed by Governor Gina Raimondo on September 26, 2016.
The law includes removing a prescription drug from its plan formulary and making any change in the preferred or tiered cost-sharing status of a covered prescription drug. This legislation sought parity with Medicare Part D’s written notification process that informs subscribers at least sixty (60) days prior to changes to prescription drug plan formulary, changes in tiering levels and cost sharing. Prior notification ensures there is fairness and adequacy in notice with opportunity to begin an appeal process for all patients who rely on medications for their well-being and safety.
The National MS Society believes people should have increased access to information, education, and resources to make healthier choices, understand and manage their own healthcare, and live healthier lives. As consumers’ experiences with their health plans increase, the National MS Society seeks state policy solutions that address the lack of benefit information and to make plan processes to access treatments more transparent to ensure patient access to the health care they need. Among the most challenging issues is the need for detailed information about prescription drug benefits, provider networks, out-of-pocket costs, and lack of notifications when benefits change. As the National MS Society continues to advocate for a more transparent healthcare system that provides those living with MS the necessary information to make informed decisions, this legislation can be considered an important success.
About the Greater New England Chapter of the National Multiple Sclerosis (MS) Society
The National MS Society mobilizes people and resources to drive research for a cure and to address the challenges of everyone affected by MS. The Society’s Greater New England Chapter serves 21,000 individuals and families affected by MS in Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. Early and ongoing treatment with an FDA-approved therapy can make a difference for people with multiple sclerosis. Learn about your options by talking to your health care professional and by contacting the National MS Society at www.MSnewengland.org, or 1 800 FIGHT MS (344 4867).
About Multiple Sclerosis
Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.