Rhode Island Law Protects Independent Pharmacies from Surprise PBM Audits

A new state law caps on-site audits and gives the Attorney General power to enforce pharmacy audit rules

Published on Feb. 16, 2026

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Three independent pharmacies in Rhode Island were hit with surprise audits from a pharmacy benefit manager (PBM) in October 2025. The owners contacted the state Attorney General's office, which then took civil action against the PBM, Prime Therapeutics, for violating the state's recently strengthened Pharmacy Audit Act. The law now caps on-site audits to one per year per insurance carrier and gives the Attorney General authority to enforce the rules. The AG's investigation concluded with a consent agreement where Prime agreed to better document its audit procedures.

Why it matters

The case highlights the power imbalance between independent pharmacies and large PBMs, who can use audits in a 'punitive' manner that disrupts small business operations. Rhode Island's law aims to protect local pharmacies by limiting PBM audit practices, which have been a longstanding concern for independent pharmacists across the country.

The details

In October 2025, auditors from Prime Therapeutics, a major PBM, showed up unannounced at three independent pharmacies owned by the Akbar family in Rhode Island. The auditors were questioning the pharmacies' documentation of vaccine administration. This prompted the owners to contact the state Attorney General's office, which then took civil action against Prime for violating the state's Pharmacy Audit Act. The updated law, passed in 2025, caps on-site audits to one per year per insurance carrier and gives the AG authority to enforce the rules. Prime ultimately agreed to a consent decree, acknowledging it failed to properly document the reasons for the audits and agree to update its procedures.

  • On October 27, 2025, Prime Therapeutics auditors visited the three independent pharmacies.
  • On November 6, 2025, Prime asked for an exemption from the state's audit law, citing suspected fraud.
  • On February 2, 2026, the AG's investigation concluded with a consent agreement with Prime Therapeutics.

The players

Zahan Akbar

Owner of Atwood Pharmacy in Johnston, Rhode Island, one of the independent pharmacies audited by Prime Therapeutics.

Peter Neronha

The Rhode Island Attorney General who took civil action against Prime Therapeutics for violating the state's Pharmacy Audit Act.

Rebecca Kislak

Democratic state Representative who sponsored the 2025 legislation that amended the Pharmacy Audit Act.

Linda Ujifusa

Democratic state Senator who sponsored the 2025 legislation that amended the Pharmacy Audit Act.

Prime Therapeutics

A major pharmacy benefit manager (PBM) that conducted unannounced audits of three independent pharmacies in Rhode Island.

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What they’re saying

“This kind of behavior can drive up pharmacy costs, limit care choices, and harm local businesses if left unchecked. So, we checked it.”

— Peter Neronha, Rhode Island Attorney General (Press release)

“Instead of calling it an audit, they called this an investigation. They were living really in the gray at that point about how far they can stretch this law without really any accountability.”

— Ron Lanton, Government affairs director, Northeast Pharmacy Service Corporation (newsfromthestates.com)

What’s next

The judge in the case will decide on Tuesday whether or not to allow Prime Therapeutics to conduct any further audits of the three independent pharmacies.

The takeaway

Rhode Island's updated Pharmacy Audit Act demonstrates how state-level legislation can help level the playing field for independent pharmacies against the outsized influence of large pharmacy benefit managers. This case highlights the need for stronger oversight and accountability of PBM practices that can disrupt small businesses.