2022 -- H 7453

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LC004636

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Representative James N. McLaughlin

     Date Introduced: February 11, 2022

     Referred To: House Health & Human Services

     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:

     27-18-89. Co-pay cap for diagnostic imaging tests.

     (a) Every individual or group hospital or medical services plan contract delivered or

renewed in this state that provides coverage for diagnostic imaging testing, inclusive of magnetic

resonance imaging testing (MRIs), computed tomography scans (CT), ultrasound or x-ray, pursuant

to the terms of a health coverage plan shall cap the total amount that a covered person is required

to pay for a covered diagnostic imaging testing at an amount not to exceed forty dollars ($40.00).

     (b) Nothing in this section prevents a health plan from reducing a covered person’s cost

sharing to an amount less than the amount specified in subsection (a) of this section.

     (c) The office of the health insurance commissioner may use any of its enforcement powers

to obtain a health plan’s compliance with this section.

     (d) The office of the health insurance commissioner may promulgate rules and regulations

as necessary to implement and administer this section and to align with federal requirements.

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

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

     27-19-81. Co-pay cap for diagnostic imaging tests.

     (a) Every individual or group hospital or medical services plan contract delivered or

renewed in this state that provides coverage for diagnostic imaging testing, inclusive of magnetic

resonance imaging testing (MRIs), computed tomography scans (CT), ultrasound or x-ray, pursuant

to the terms of a health coverage plan shall cap the total amount that a covered person is required

to pay for a covered diagnostic imaging testing at an amount not to exceed forty dollars ($40.00).

     (b) Nothing in this section prevents a health plan from reducing a covered person’s cost

sharing to an amount less than the amount specified in subsection (a) of this section.

     (c) The office of the health insurance commissioner may use any of its enforcement powers

to obtain a health plan’s compliance with this section.

     (d) The office of the health insurance commissioner may promulgate rules and regulations

as necessary to implement and administer this section and to align with federal requirements.

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

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

     27-20-77. Co-pay cap for diagnostic imaging tests.

     (a) Every individual or group hospital or medical services plan contract delivered or

renewed in this state that provides coverage for diagnostic imaging testing, inclusive of magnetic

resonance imaging testing (MRIs), computed tomography scans (CT), ultrasound or x-ray, pursuant

to the terms of a health coverage plan shall cap the total amount that a covered person is required

to pay for a covered diagnostic imaging testing at an amount not to exceed forty dollars ($40.00).

     (b) Nothing in this section prevents a health plan from reducing a covered person’s cost

sharing to an amount less than the amount specified in subsection (a) of this section.

     (c) The office of the health insurance commissioner may use any of its enforcement powers

to obtain a health plan’s compliance with this section.

     (d) The office of the health insurance commissioner may promulgate rules and regulations

as necessary to implement and administer this section and to align with federal requirements.

     SECTION 4. Chapter 27-41 of the General Laws entitled “Health Maintenance

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

     27-41-94. Co-pay cap for diagnostic imaging tests.

     (a) Every individual or group hospital or medical services plan contract delivered or

renewed in this state that provides coverage for diagnostic imaging testing, inclusive of magnetic

resonance imaging testing (MRIs), computed tomography scans (CT), ultrasound or x-ray, pursuant

to the terms of a health coverage plan shall cap the total amount that a covered person is required

to pay for a covered diagnostic imaging testing at an amount not to exceed forty dollars ($40.00).

     (b) Nothing in this section prevents a health plan from reducing a covered person’s cost

sharing to an amount less than the amount specified in subsection (a) of this section.

     (c) The office of the health insurance commissioner may use any of its enforcement powers

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to obtain a health plan’s compliance with this section.

     (d) The office of the health insurance commissioner may promulgate rules and regulations

as necessary to implement and administer this section and to align with federal requirements.

     SECTION 5. 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 – ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would limit an individual’s co-pay for any diagnostic imaging tests, inclusive of

magnetic resonance imaging tests (MRIs), computed tomography scans (CT), ultrasound or x-ray,

to forty dollars ($40.00).

     This act would take effect upon passage.

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LC004636

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