A Washington D.C.-based nonprofit spent over $400,000 on ads in the final weeks of the 2025 Rhode Island legislative session to persuade state lawmakers to vote against legislation aimed at protecting a federal drug pricing mandate from manufacturer interference.
But it wasn’t enough.
The General Assembly ultimately passed the tripartisan legislation to prevent drugmakers and pharmacy benefit managers (PBM) from controlling patient access to discounted medications under the federal 340B Drug Pricing Program. The program, which began in 1992, requires manufacturers to offer steep discounts to participating providers, often small community health centers and safety net hospitals.
Gov. Dan McKee signed the companion bills by Rep. Jon D. Brien, a Woonsocket independent, and Sen. Bridget Valverde, a North Kingstown Democrat, into law on June 27. The legislation had overwhelming support in the House, including from nine of the chamber’s 10 Republicans. Both bills saw unanimous approval by the Senate.
Rhode Island now joins a growing list of states that have passed laws to defend contract pharmacy use or prohibit PBM discrimination against 340B entities. The laws have come in response to restrictions imposed by manufacturers on 340B participants limiting where prescriptions can be dispensed, especially those filled at contract pharmacies, like a patient’s local CVS or Walgreens, that fill prescriptions on a provider’s behalf.
The law allowing Rhode Island’s new protections takes effect Oct. 1, 2025.
Rhode Island’s 340B program received a boost from the state’s fiscal 2026 budget, which called on the Executive Office of Health and Human Services to align itself with some of the same actions in Brien and Valverde’s bills, such as preventing manufacturer discrimination against contract pharmacies. The budget clause also asks for annual reports from 340B providers and oversight from the Auditor General.
The new law is a blow to the Big Pharma lobbyists who have been critical of 340B, arguing that hospitals and pharmacies exploit the federal program for profit. Such was the message in the 789 TV and radio spots urging Rhode Island lawmakers to “stop 340B abuse today” purchased by Community Action for Responsible Hospitals during the final weeks of the legislative session.
“Rhode Island families go broke, CEOs get rich,” stated a TV ad that aired on WJAR Channel 10 during the weeks surrounding the end of the legislative session, which wrapped up June 21.
Community Action for Responsible Hospitals’ website describes its membership as “patient-focused stakeholders,” including labor unions, faith leaders, health care providers, consumer advocates, and public interest groups.
The Washington-D.C. group spent $178,881 to air ads on Channel 10 and cable, along with radio stations WPRO and WEAN, between mid May and late June, according to filings made with the Federal Communications Commission (FCC).
“I saw a couple of the ads on TV, and it struck me,” Matthew Ulricksen, an associate professor of political science for the Community College of Rhode Island, said in an interview. “I don’t really remember seeing much of an advertising campaign by interest groups around a state budget debate before.”
Ulricksen said the little information available suggests the group could be Big Pharma companies masquerading as a pro-labor, pro-consumer.
“If Bristol-Myers Squibb Company runs an ad on TV in Rhode Island, that’s going to raise people’s eyebrows,” he said. “[Instead], they look like a public interest group that is doing this for a noble purpose rather than corporations that are lobbying to protect their bottom lines.”
The ads also caught Brien’s eyes and ears. The lawmaker said he believes the money to pay for them came from pharmaceutical companies.
“I felt that every time they ran that ad that it helped our cause,” Brien said in an interview. “I was able to say the only opposition we have is Big Pharma — this is them and they’re lying to you, as usual.”
Community Action for Responsible Hospitals lists transparency in hospital ownership and pricing among its primary policy priorities. But as a not-for-profit 501(c)(4), the group is not required to reveal its donors. However, it must file a statement of revenues and expenses annually with the IRS, though the organization is not listed on the federal government’s nonprofit database.
The group’s social media presence consists of accounts on X, Instagram, LinkedIn and YouTube — all with relatively few followers and posts since going online in the spring. The YouTube channel has one subscriber and no content at all.
“That’s exactly what they do — it’s slapdash,” Ulricksen said of pop-up lobbying groups.
Pro-labor or not?
Community Action for Responsible Hospitals’ website claims that 340B “hurts labor.” But the labor union representing Rhode Island’s health care workers backed the state’s 340B legislation. SEIU 1199NE wrote to the House Committee on Health and Human Services in April that the bill was a way the state could “help prevent the collapse of our community health infrastructure.”
The group is not on the radar of the state’s most powerful union leader.
“That does not sound familiar to me,” Rhode Island AFL-CIO President Patrick Crowley said when asked if he had heard of Community Action for Responsible Hospitals.
The Rhode Island Secretary of State’s lobby tracker database lists at least 13 pharmaceutical companies registered to lobby the General Assembly in 2025. Four — Eli Lilly, Bristol Myers-Squibb Company, Amgen Inc., and Sanofi — indicated their opposition to the 340B legislation, H5634 and S114. Johnson & Johnson, Alexion, GlaxoSmithKline, Purdue Pharma, Otsuka, Novartis, the Takeda Pharmaceutical Company, and Vertex did not list any stance on the legislation.
Merck & Co. was listed as “watching” the companion bills, according to its filings with the state.
The Pharmaceutical Research and Manufacturers of America (PhRMA), one of several trade groups registered to lobby at the State House, testified in opposition before the House Committee on Health Human Services on April 10.
Rhode Island Current reached out to PhRMA to inquire about its familiarity with Community Action for Responsible Hospitals.
“I have not heard of them,” Stami Turk, director of state public affairs for PhrMA, said in a phone interview.
So, who’s behind the group?
Community Action for Responsible Hospitals officially registered as a lobbyist with the Rhode Island Secretary of State’s Office on May 27 — less than a month before the end of the 2025 legislative session. Faith Cybowski, spokesperson for the office, said it’s very common for entities to pop up late into the legislative year.
“The requirement is just that the lobbyist registers within seven days of conducting the lobbying activity and then files reports as required,” Chybowski said via text message.
Two reports detailing the group’s lobbying activity were submitted to the state. The reports list no contributions related to opposing the 340B legislation. But two disbursements totaling $404,845 are listed for advertising by a company listed as “Fifty-Six Media LLC.”
The ads were not done by the New York City firm of that name, its founder and CEO confirmed via email Monday morning.
“We have never worked with budgets this large, nor have we ever done business with a RI based firm,” wrote Katelyn Glass.
She referred Rhode Island Current to the website of a separate firm named “Fifty-Six Digital” based out of Grahamsville, New York, according to its website full of placeholder text. The firm’s owner, Chad Phillips, did not immediately respond to request for comment.
The reports list one lobbyist: Michael Kapsa, with a phone number and email address. The voicemail greeting indicates the user has a Google Voice number to handle calls. Rhode Island Current left three messages, none of which were returned.
But Kapsa responded to an email with a brief statement critical of Valverde’s legislation:
“Senate Bill 114 lacks transparency and oversight and would accelerate the misuse of the 340B program that drives up costs for Rhode Island patients, union members, and underserved communities,” Kapsa wrote. “It gives a blank check to bad actors who abuse 340B to pad profits instead of helping patients.”
Kapsa is the chief financial officer for SolidaritUS Health, a Washington D.C.-based health care group that partners with local insurance exchanges that share claims databases to develop primary care programs for employer and labor union employees.
SolidaritUS was founded in 2017 as an offshoot of “America’s Agenda,” an alliance of labor, business, health care providers and policymakers with Kapsa serving as its chief economist. The company’s chairman is Dick Gephardt, the former Democratic Missouri congressman turned lobbyist, whose firm has represented the multinational pharmaceutical company Bayer.
In 2021, Kapsa was tapped by the Biden administration to join a federal advisory committee meant to help the U.S. Department of Labor develop a standard format for group health plans to all payer claims databases.
FCC filings list Kapsa’s name as the primary ad buyer in Rhode Island. They also name Dr. Steven Sleigh as the president of Community Action for Responsible Hospitals. Sleigh is a D.C.-area consultant who previously worked for the International Association of Machinists and Aerospace Workers, according to his LinkedIn profile.
The names of both Sleigh and Kapsa appear on a 990 tax form submitted by the Pbm Accountability Project, a pop-up lobby that aired ads in Washington, D.C. in 2023 as Congress considered various bills meant to ensure PBMs keep drug prices low.
Rhode Island Current reached out to Sleigh on June 30 and followed up on July 3.
“Really don’t have any comment on the Rhode Island situation,” Sleigh said in an email response on July 3.
Community Action for Responsible Hospitals also led lobbying efforts against legislation to protect the 340B program in Oregon and Illinois. Their lobbying was unsuccessful in Oregon, while the bill in Illinois is still under consideration.
Brien likened the group’s expensive efforts in Rhode Island to “the last gasp of a dying man.”
“They could have thrown a million dollars at this thing and you weren’t going to move the legislators in the House and the Senate on this one,” he said. “You could have run them every 10 minutes and it wouldn’t have mattered.”
This story was originally published by the Rhode Island Current.
Correction: A previous version of this story misstated the nature of the business relationship between Fifty-Six Strategies and Community Action for Responsible Hospitals.
