2019 -- H 5922

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LC002028

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE -- COMMUNICATION ACCESS

     Introduced By: Representatives Handy, Jacquard, Vella-Wilkinson, Caldwell, and Serpa

     Date Introduced: March 28, 2019

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18-85. Communication access services.

     (a) Every individual or group health insurance contract, or every individual or group

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

or renewed in this state on or after January 1, 2020, shall provide coverage for effective

communication access services for the deaf and hard of hearing patients or identified clients.

     (b) For the purposes of this section:

     (1) "Communication access services" means any effective communication access services

recognized by either the Rehabilitation Act of 1973 or the Americans with Disabilities Act to

guarantee full communication access between the patients or identified clients who are deaf and

hard of hearing and doctors or other health care professionals to ensure that each party understood

their health needs and treatments. Examples of effective communication access services are sign

language interpreters for the deaf, certified deaf interpreters, oral interpreter, tactile interpreters,

Communication Access RealTime (CART) service, video remote interpreting service for the deaf,

remote CART service, etc.

     (c) This section shall not apply to equipment purchased as part of communication access

accommodations such as TTYs, videophones, assistive listening devices, etc.

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-77. Communication access services.

     (a) Every individual or group health insurance contract, or every individual or group

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

or renewed in this state on or after January 1, 2020, shall provide coverage for effective

communication access services for the deaf and hard of hearing patients or identified clients.

     (b) For the purposes of this section:

     (1) "Communication access services" means any effective communication access services

recognized by either the Rehabilitation Act of 1973 or the Americans with Disabilities Act to

guarantee full communication access between the patients or identified clients who are deaf and

hard of hearing and doctors or other health care professionals to ensure that each party understood

their health needs and treatments. Examples of effective communication access services are sign

language interpreters for the deaf, certified deaf interpreters, oral interpreter, tactile interpreters,

Communication Access RealTime (CART) service, video remote interpreting service for the deaf,

remote CART service, etc.

     (c) This section shall not apply to equipment purchased as part of communication access

accommodations such as TTYs, videophones, assistive listening devices, etc.

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-73. Communication access services.

     (a) Every individual or group health insurance contract, or every individual or group

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

or renewed in this state on or after January 1, 2020, shall provide coverage for effective

communication access services for the deaf and hard of hearing patients or identified clients.

     (b) For the purposes of this section:

     (1) "Communication access services" means any effective communication access services

recognized by either the Rehabilitation Act of 1973 or the Americans with Disabilities Act to

guarantee full communication access between the patients or identified clients who are deaf and

hard of hearing and doctors or other health care professionals to ensure that each party understood

their health needs and treatments. Examples of effective communication access services are sign

language interpreters for the deaf, certified deaf interpreters, oral interpreter, tactile interpreters,

Communication Access RealTime (CART) service, video remote interpreting service for the deaf,

remote CART service, etc.

     (c) This section shall not apply to equipment purchased as part of communication access

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accommodations such as TTYs, videophones, assistive listening devices, etc.

     SECTION 4. Section 27-38.2-2 of the General Laws in Chapter 27-38.2 entitled

"Insurance Coverage for Mental Illness and Substance Abuse" is hereby amended to read as

follows:

     27-38.2-2. Definitions.

     For the purposes of this chapter, the following words and terms have the following

meanings:

     (1) "Communication access services" means any effective communication access services

recognized by either the Rehabilitation Act of 1973 or the Americans with Disabilities Act to

guarantee full communication access between the patients or identified clients who are deaf and

hard of hearing and doctors or other health care professionals to ensure that each party understood

their health needs and treatments. Examples of effective communication access services are sign

language interpreters for the deaf, certified deaf interpreters, oral interpreter, tactile interpreters,

Communication Access RealTime (CART) service, video remote interpreting service for the deaf,

remote CART service, etc.

     This definition shall not apply to equipment purchased as part of communication access

accommodations such as TTYs, videophones, assistive listening devices, etc.

     (1)(2) "Financial requirements" means deductibles, copayments, coinsurance, or out-of-

pocket maximums.

     (2)(3) "Group health plan" means an employee welfare benefit plan as defined in 29

U.S.C. § 1002(1) to the extent that the plan provides health benefits to employees or their

dependents directly or through insurance, reimbursement, or otherwise. For purposes of this

chapter, a group health plan shall not include a plan that provides health benefits directly to

employees or their dependents, except in the case of a plan provided by the state or an

instrumentality of the state.

     (3)(4) "Health insurance plan" means health insurance coverage offered, delivered, issued

for delivery, or renewed by a health insurer.

     (4)(5) "Health insurers" means all persons, firms, corporations, or other organizations

offering and assuring health services on a prepaid or primarily expense-incurred basis, including

but not limited to, policies of accident or sickness insurance, as defined by chapter 18 of this title;

nonprofit hospital or medical service plans, whether organized under chapter 19 or 20 of this title

or under any public law or by special act of the general assembly; health maintenance

organizations, or any other entity that insures or reimburses for diagnostic, therapeutic, or

preventive services to a determined population on the basis of a periodic premium. Provided, this

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chapter does not apply to insurance coverage providing benefits for:

     (i) Hospital confinement indemnity;

     (ii) Disability income;

     (iii) Accident only;

     (iv) Long-term care;

     (v) Medicare supplement;

     (vi) Limited benefit health;

     (vii) Specific disease indemnity;

     (viii) Sickness or bodily injury or death by accident or both; and

     (ix) Other limited benefit policies.

     (5)(6) "Mental health or substance use disorder" means any mental disorder and

substance use disorder that is listed in the most recent revised publication or the most updated

volume of either the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by

the American Psychiatric Association or the International Classification of Disease Manual (ICO)

published by the World Health Organization; provided, that tobacco and caffeine are excluded

from the definition of "substance" for the purposes of this chapter.

     (6)(7) "Non-quantitative treatment limitations" means: (i) Medical management

standards; (ii) Formulary design and protocols; (iii) Network tier design; (iv) Standards for

provider admission to participate in a network; (v) Reimbursement rates and methods for

determining usual, customary, and reasonable charges; and (vi) Other criteria that limit scope or

duration of coverage for services in the treatment of mental health and substance use disorders,

including restrictions based on geographic location, facility type, and provider specialty.

     (7)(8) "Quantitative treatment limitations" means numerical limits on coverage for the

treatment of mental health and substance use disorders based on the frequency of treatment,

number of visits, days of coverage, days in a waiting period, or other similar limits on the scope

or duration of treatment.

     SECTION 5. Chapter 27-38.2 of the General Laws entitled "Insurance Coverage for

Mental Illness and Substance Abuse" is hereby amended by adding thereto the following section:

     27-38.2-71. Communication access services.

     (a) Every individual or group health insurance contract, or every individual or group

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

or renewed in this state on or after January 1, 2020, shall provide coverage for effective

communication access services for the deaf and hard of hearing patients or identified clients.

     (b) This section shall not apply to equipment purchased as part of communication access

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accommodations such as TTYs, videophones, assistive listening devices, etc.

     SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-90. Communication access services.

     (a) Every individual or group health insurance contract, or every individual or group

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

or renewed in this state on or after January 1, 2020, shall provide coverage for effective

communication access services for the deaf and hard of hearing patients or identified clients.

     (b) For the purposes of this section:

     (1) "Communication access services" means any effective communication access services

recognized by either the Rehabilitation Act of 1973 or the Americans with Disabilities Act to

guarantee full communication access between the patients or identified clients who are deaf and

hard of hearing and doctors or other health care professionals to ensure that each party understood

their health needs and treatments. Examples of effective communication access services are sign

language interpreters for the deaf, certified deaf interpreters, oral interpreter, tactile interpreters,

Communication Access RealTime (CART) service, video remote interpreting service for the deaf,

remote CART service, etc.

     (c) This section shall not apply to equipment purchased as part of communication access

accommodations such as TTYs, videophones, assistive listening devices, etc.

     SECTION 7. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- COMMUNICATION ACCESS

***

     This act would require accident and sickness insurance policies, nonprofit hospital and

medical service insurance policies, mental illness and substance abuse policies and health

maintenance insurance policies to provide coverage for communication access services for the

hard-of-hearing.

     This act would take effect upon passage.

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LC002028

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