§ 27-29.1-3 - Fair competition – Requirements for carriers offering pharmacy networks. - Rhode Island Statutes

SECTION 27-29.1-3

   § 27-29.1-3  Fair competition –Requirements for carriers offering pharmacy networks. – (a) An insurer that offers insureds a restricted pharmacy network shall, insoliciting, arranging, competitively bidding, contracting for, and operatingsuch a network, comply with the following requirements for the purpose ofpromoting fair and competitive bidding, regardless of when the restrictedpharmacy network was established:

   (1) Conduct and complete an open bidding process before March1, 2005 and at least once every three (3) years thereafter;

   (2) Provide notice to eligible bidders of the insurer'sintent to solicit bids for participation in a restricted pharmacy network;

   (3) Inform eligible bidders of the date such bids will besolicited;

   (4) Provide eligible bidders with information on anidentical, equal and uniform basis, including, but not limited to, bidprocedure information, financial and utilization information needed to make aninformed competitive bid, criteria to be used in awarding a restricted pharmacynetwork contract and proposed contractual requirements for the restrictedpharmacy network;

   (5) Provide eligible bidders with at least thirty (30) daysto prepare and submit bids between the bid solicitation date and the bidsubmission deadline;

   (6) Open all bids:

   (i) At a previously specified time, which shall not be morethan thirty (30) days after the bid submission deadline; and

   (ii) In a public manner, provided, that certain, informationcontained in said bids may be held as confidential from public reviewconsistent with regulations promulgated by the director regarding thedisclosure of proprietary data or information submitted by any bidders; and

   (7) Select a successful bidder using solely the criteriaprovided to eligible bidders pursuant to subsection (a)(4) above, applied in auniform manner.

   (b) An insurer shall neither exclude nor favor any individualpharmacy, or group or class of pharmacies, in the design of a competitive bidinvolving restricted or nonrestricted pharmacy networks in compliance with therequirements of this section. An entity and its affiliates that assists aninsurer in the development of the bid, design, bid specifications or the bidprocess, or assists in the review or evaluation of said bids, shall beprohibited from bidding on such a contract.