2012 -- S 2557

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LC01944

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

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A N A C T

RELATING TO BUSINESSES AND PROFESSIONS - PATIENT PROTECTION ACT

     Introduced By: Senators Gallo, Doyle, and Tassoni

     Date Introduced: February 28, 2012

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 5-48.1-3 of the General Laws in Chapter 5-48.1 entitled "Patient

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Protection Act" is hereby amended to read as follows:

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     5-48.1-3. Prohibited acts. -- (a) Whoever knowingly and willfully solicits or receives

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any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or

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covertly, in cash or in kind; (1) in return for referring an individual to a person for the furnishing,

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or arranging for the furnishing, of any health care service or item; or (2) in return for purchasing,

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leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering, any health

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care good, facility, service, or item is guilty of a misdemeanor, and upon conviction, shall be

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fined not more than one thousand dollars ($1,000), or imprisoned for not more than one year, or

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both.

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      (b) Whoever knowingly and willfully offers or pays any remuneration (including any

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kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind, to any

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person to induce that person: (1) to refer an individual to a person for the furnishing, or arranging

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for the furnishing of, any health care item or service; or (2) to purchase, lease, order, or arrange

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for or recommend purchasing, leasing, or ordering any health care good, facility, service, or item

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is guilty of a misdemeanor, and upon conviction, shall be fined not more than one thousand

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dollars ($1,000), or imprisoned for not more than one year, or both.

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      (c) Subsections (a) and (b) of this section do not apply to:

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      (1) A discount or other reduction in price obtained by a provider of services or other

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entity if the reduction in price is properly disclosed and appropriately reflected in the costs

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claimed or charges made by the provider;

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      (2) Any amount paid by an employer to an employee (who has a bona fide employment

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relationship with the employer) for employment in the provision of health care services;

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      (3) Any amount paid by a vendor of goods or services to a person authorized to act as a

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purchasing agent for a group of individuals or entities who are furnishing health care services, if:

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      (i) The person has a written contract, with each individual or entity, which specifies the

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amount to be paid the person, which amount may be a fixed amount or a fixed percentage of the

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value of the purchases made by each individual or entity under the contract; and

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      (ii) In the case of an entity that is a provider of services, the person shall disclose (in the

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form and manner that the director requires) to the entity and, upon request, to the director, the

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amount received from each vendor with respect to purchases made by or on behalf of the entity.

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      (4) A waiver of any coinsurance under part B of title XVIII by a federally qualified

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health care center with respect to an individual who qualifies for subsidized services under a

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provision of the Public Health Service Act.

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      (5) Any payment practice specified in regulations promulgated pursuant to section 14(a)

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of the Medicare and Medicaid Patient and Program Protection Act of 1987, (see 42 U.S.C. section

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1320a-7b), or to chapter 66.2 of title 42 relating to Pharmaceutical Assistance to the Elderly.

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      (6) A discount or other reduction in price on a health care item or a limited-time free

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supply of such item which is made available to an individual, if such item is provided through a

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"point of sale" or "mail-in" coupon or through other similar means, for either: (i) a drug licensed

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by the United States food and drug administration (FDA) as a biological product, pursuant to

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section 351 of the public health services act, 42 USC 262 or by FDA regulations and policies; or

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(ii) a drug for which there is no other alternative within the same therapeutic class, as defined and

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identified in the U.S. pharmacopeia/national formulary compendium.

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     SECTION 2. This act shall take effect upon passage.

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LC01944

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO BUSINESSES AND PROFESSIONS - PATIENT PROTECTION ACT

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     This act would limit the “point of sale”/”mail in coupon” exemption under the Patient

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Protection Act to certain products determined by the FDA to be biological products pursuant to

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federal law, or to products for which there is no generic alternative.

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     This act would take effect upon passage.

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LC01944

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