 |
|
6/18/2025
|
Assembly OKs bills to make it easier for patients to get prescriptions
|
 Sponsored by Sen. Lauria and Rep. McGaw, bills help address frustrating delays and provide help amid primary care crisis
STATE HOUSE – The General Assembly today approved two bills sponsored by Sen. Pamela J. Lauria and Rep. Michelle McGaw to help patients get their prescriptions expeditiously in situations when their prescriber can’t be reached, or when their insurers want to substitute equivalent drugs or devices. Both bills now head to the governor.
The first bill (2025-H 5633, 2025-S 0483aa) allows pharmacists, in the event they receive a request for a prescription refill and are unable to readily obtain refill authorization from the prescriber, or the patient no longer has a prescriber, to dispense a one-time refill for continuation of the patient’s therapy for no more than 100 days, under certain conditions. The bill now goes to the governor.
The sponsors introduced the measure to prevent interruptions in necessary medical treatment, particularly for those with chronic conditions.
“This bill is to help patients and providers in an environment where we simply do not have enough doctors, particularly primary care providers. Often a patient needs an appointment before the prescriber can authorize a refill, but it might be weeks or even months before an appointment is available. And in cases where a provider retires or stops practicing in Rhode Island, it can be extremely difficult for patients to find a new one. Until they do, they usually don’t have anyone who can authorize that refill,” said Representative McGaw (D-Dist. 71, Portsmouth, Tiverton, Little Compton). “Interrupting a patient’s prescription for reasons other than medical ones is not in their best interest. This bill provides an avenue for pharmacists — who are extensively trained, licensed and understand the benefits and risks of pharmaceuticals — to make a professional determination about whether to dispense a single refill as a stopgap measure when the prescriber can’t be reached or is no longer practicing.”
The problem is one with which both sponsors are familiar; Representative McGaw is a pharmacist, and Senator Lauria is a primary care nurse practitioner.
“Primary care is in crisis in Rhode Island, and we need every tool available to protect patients’ health,” said Senator Lauria (D-Dist. 32, Barrington, Bristol, East Providence). “Currently, if a pharmacist can’t
reach a patient’s provider to authorize a refill, whether it’s because they no longer have a provider, they can’t get an appointment or because their provider’s staff is struggling to keep up with the enormous administrative burdens they all face, the patient can’t get the medication. In some cases, that’s a life-threatening situation, and unfortunately, it’s becoming more common every day. With this change, pharmacists would be equipped to protect Rhode Islanders from the risks of being forced off medication because no one can authorize their refill.”
With the closure this month of Anchor Medical Associates, which is where 25,000 Rhode Islanders see their PCPS, there will soon be thousands more Rhode Islanders looking for PCPs, and many will likely find themselves in need of prescription refills before they find a new one.
Under the bill, the pharmacist would be allowed to provide the refill only if the medication is essential to life or continuation of therapy for a chronic condition, and in the pharmacist’s professional judgment, its interruption might produce undesirable health consequences or may cause physical or mental discomfort. The dispensing pharmacist would have to notify the prescriber within seven business days, or if no current prescriber exists, document that information within the pharmacy’s records. The bill would not apply to Schedule II-V narcotics.
The second bill (2025-H 5855A, 2025-H 0482A) will streamline the process of substituting therapeutic equivalent prescription drugs or devices. Such substitutions typically occur at the request of an insurer, and the current process requires the pharmacist to contact the patient’s prescriber for approval before filling it.
The legislation will permit the pharmacist to fill the prescription with the substitute without having to get authorization from the prescriber, as long as the substitute is therapeutically equivalent to the original product, approved for the same indication, use, and if applicable, formulation. The pharmacy would still need to inform the prescriber of the substitution within seven days. The bill only enables such substitution; it does not require the pharmacist to perform the substitution, nor does it require the patient to accept it.
“This bill will cut down on needless delays in filling prescriptions. For example, a health care provider might write a prescription specifying a specific brand of inhaler, but the patient’s insurance could come back and say they cover a different brand of the same drug. Currently, the pharmacist has to contact the prescriber and get that substitution approved before they can fill it, even though there’s no significant difference between the products. This bill enables pharmacists to use their professional judgment to perform the substitution if appropriate, cutting down on needless back-and-forth,” said Representative McGaw.
Said Senator Lauria, “This is one small way to ease the enormous administrative burden on health care providers and their staffs, who spend so much of their time communicating with pharmacies and insurers. At a time when Rhode Island has such a critical shortage of primary care providers, any way we can streamline administrative tasks such as this one will help providers and patients alike. The less time providers spend on administrative tasks, the more time they can devote to providing care to patients.”
For more information, contact:
Meredyth R. Whitty, Publicist
State House Room 20
Providence, RI 02903
(401) 222-1923
|
|