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4/2/2026
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Senate approves Bissaillon bill to clear Medicaid roadblocks for antipsychotic, anticonvulsant medicines
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STATE HOUSE – The Senate today approved legislation sponsored by Sen. Jacob E. Bissaillon to eliminate significant roadblocks to effective treatment for Rhode Islanders who rely on Medicaid for antipsychotic or anticonvulsant prescriptions.
The legislation (2026-S 2385) would prohibit the Rhode Island Medicaid program and the managed care organizations contracted by it from requiring prior authorization or step therapy for coverage of any drug classified as an antipsychotic or anticonvulsant.
“About 41,000 Rhode Islanders live with a serious mental illness – over 5% of the population — and that proportion rises to one in four among unhoused Rhode Islanders. More than 11,100 individuals are living with epilepsy here in Rhode Island,” said Senator Bissaillon (D-Dist. 1, Providence), who chairs the Senate’s Housing and Municipal Government Committee. “People treated with antipsychotics and anticonvulsants — both medications people need immediately to be able to live functionally — shouldn’t have to ‘fail first’ on drugs preferred by their insurance. Medication decisions should be made by the patient and their health care provider based on the patient’s best medical interests.”
Prior authorization requirements are a cost-control measure by insurers that cause delays in care. A recent American Medical Association survey reported that 82% of physicians reported prior authorization can lead to their patients abandoning treatment, and that 34% reported it had caused a serious adverse event for one or more patients in their care.
Step therapy is another insurer cost-saving measure, requiring patients first try and fail on one or more of their insurer’s preferred therapies before the insurer will approve the one their physician recommends.
Due to the nature of these diseases, adherence to medication is already a significant challenge, and more than half of psychiatrists surveyed by the National Council for Behavioral Health say formulary restrictions, prior authorizations and fail-first protocols are the most frequent roadblock to optimal treatment.
“A patient’s non-adherence to their medications can result in devastating consequences for them, including emergency department visits, hospital admissions, rehospitalization, imprisonment and homelessness,” said Senator Bissaillon. “The dollars saved by insurers with these tactics do not justify the significant human, economic and social costs.”
Nearly half of U.S. states, including Connecticut and Maine, have similar laws. The bill now goes to the House of Representatives, where House Municipal Government and Housing Committee Chairman Stephen M. Casey (D-Dist. 50, Woonsocket) is sponsoring companion legislation (2026-H 7587).
For more information, contact:
Meredyth R. Whitty, Publicist
State House Room 20
Providence, RI 02903
(401) 222-1923
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