Attorney General Neronha announces actions to address health care crisis in Rhode Island

(WJAR) — Rhode Island Attorney General Peter Neronha announced several initiatives to address the state’s health care crisis on Wednesday.

The attorney general’s announcement promises both immediate and long-term solutions to problems plaguing Rhode Island’s health care system.

At the press event, Neronha announced a wide range of initiatives targeting health care crisis, including legislative action to increase Medicaid primary care rates, legislation which will prohibit nearly 100% of prior authorization requirements for primary care providers, new protections from the attorney general’s office and more.

“We have to stabilize primary care right now. Primary care doctors are the air traffic controllers of our health care system. They’re the ones that analyze our problem, send us to the tests we need, send us to the specialists we need,” he said.

The attorney general also said his office also filed lawsuits against three Pharmacy Benefit Managers– CVS Caremark, Express Scripts, and Optum.

He alleges the groups deceptively increased costs of prescription drugs and harmed local businesses.

“Because there’s money to be made in health care, there are bad actors who will exploit the system to the detriment of Rhode Islanders, as we’ve seen with PBMs and private equity firms. At the same time, our health care system’s overall revenue has suffered in part because of Medicaid reimbursement rates that are far, far too low – and we need to simply bite the bullet and raise them, now,” Neronha said.

In a statement to NBC 10, a CVS spokesperson said, “It’s surprising and unfortunate that Rhode Island’s attorney general would use biased and incorrect assertions about our industry to needlessly attack a hometown company. CVS Health contributes nearly $3 billion of positive economic activity in Rhode Island each year, and we employ more than 7,000 colleagues across the state… The AG’s rhetoric about protecting independent pharmacies is inaccurate and misleading. There are more independent pharmacies operating in RI today than there were six years ago. Further, CVS Caremark reimburses independent pharmacies at higher rates than it does CVS Pharmacy.”

Neronha also proposed regulations to require a pre-merger notification certain material corporate transactions involving medical practice groups and issuing an advanced notice of proposed rulemaking regarding artificial intelligence.

It was this time last month Gov. Dan McKee released his own multi-step plan to address Rhode Island’s primary care system, a plan the attorney general was not impressed by.

It included $5 million in grants for primary care practices to help recruit and retain doctors, accelerating a Medicaid rate review for primary care providers requiring commercial insurers to increase reimbursement funding, and expanding the primary care student loan forgiveness program.

On Wednesday, McKee responded to the attorney general’s press conference, discussing some of his own actions in regards to the attorney general’s proposals.

“As for eliminating prior authorization requirements, recently the state put in place new regulations that reduce prior authorization requirements, with a focus on those managed by primary care providers,” McKee’s spokesperson said in a statement. “While the attorney general is requesting authorization to petition the court to place a hospital into receivership if it becomes financially unstable, Governor McKee has asked to receive and review quarterly unaudited statements to create an early warning system BEFORE a health care organization becomes financially unstable. This would allow the state to work with and not against those health care entities that need support.”

This comes after 25,000 patients were told they would be losing their principal care providers with the closure of Anchor Medical by the end of June.

The attorney general’s office said in-depth information about the initiatives can be found on the office’s website.

NBC 10’s Abbey Buttacavoli and Gabrielle Caracciolo contributed to this report.