Chapter 202
2012 -- S 2129
Enacted 06/11/12
A N A C T
RELATING TO
INSURANCE
Introduced
By: Senators Nesselbush, P Fogarty, Sosnowski, Cote, and
Date Introduced: January 18, 2012
It is enacted by the General
Assembly as follows:
SECTION 1. Chapter 27-20 of the General Laws entitled
"Nonprofit Medical Service
Corporations" is
hereby amended by adding thereto the following section:
27-20-65. Primary
care provider designation requirement. – 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, 2013, shall require that the
subscriber and each dependent designate a
participating primary care provider and the insurer shall collect
the designation from the insured.
Designation of a primary care provider shall not be a
condition of enrollment and failure to
designate a primary care provider shall not constitute grounds
for cancellation of coverage. For
purposes of this section, “primary care provider” means the
physician, practice or other medical
provider considered by the insured to be his or her usual
source of medical care.
SECTION 2. Chapter 27-19 of the General Laws entitled
"Nonprofit Hospital Service
Corporations" is
hereby amended by adding thereto the following section:
27-19-69.
Primary care provider designation requirement. – 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, 2013, shall require that the
subscriber and each dependent designate a
participating primary care provider and the insurer shall collect
the designation from the insured.
Designation of a primary care provider shall not be a
condition of enrollment and failure to
designate a primary care provider shall not constitute grounds
for cancellation of coverage. For
purposes of this section, “primary care provider” means the
physician, practice or other medical
provider considered by the insured to be his or her usual
source of medical care.
SECTION 3. Chapter 27-18 of the General Laws entitled
"Accident and Sickness
Insurance Policies" is
hereby amended by adding thereto the following section:
27-18-78.
Primary care provider designation requirement. – (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, 2013, shall require that the
subscriber and each dependent designate a
participating primary care provider and the insurer shall collect
the designation from the insured.
Designation of a primary care provider shall not be a
condition of enrollment and failure to
designate a primary care provider shall not constitute grounds
for cancellation of coverage. For
purposes of this section, “primary care provider” means the
physician, practice or other medical
provider considered by the insured to be his or her usual
source of medical care.
(b) Requirements for
designating a primary care provider enumerated in subsection (a)
shall not apply to insurance coverage providing benefits
for:
(1) Hospital
confinement indemnity;
(2) Disability
income;
(3) Accident only;
(4) Long-term care;
(5) Medicare
supplement;
(6) Limited benefit
health;
(7) Specified disease
indemnity;
(8) Sickness or
bodily injury or death by accident or both; or
(9) Other limited
benefit policies.
SECTION
4. Chapter 27-41 of the General Laws entitled "Health Maintenance
Organizations" is hereby amended by adding
thereto the following section:
27-41-82. Primary
care provider designation requirement. -- 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, 2013, shall require that the
subscriber and each dependent designate a
participating primary care provider and the insurer shall collect
the designation from the insured.
Designation of a primary care provider shall not be a
condition of enrollment and failure to
designate a primary care provider shall not constitute grounds
for cancellation of coverage. For
purposes of this section, “primary care provider” means the
physician, practice or other medical
provider considered by the insured to be his or her usual
source of medical care.
SECTION
5. The health insurance commissioner is authorized to promulgate
regulations
to implement this act.
SECTION 6. This act shall take effect on January 1, 2013.
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LC00414
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