§ 42-62-14. Discrimination by insurance vendors — Payment to uncertified providers of health services.
(a) It shall be the duty of any insurer that issues to a resident of Rhode Island a qualified program of health benefits:
(1) To offer, at the option of the applicant, an individual policy or contract providing either (i) the hospital and physicians’ service benefits described in § 42-62-10(c), or (ii) all of the benefits described in § 42-62-10(c), to any resident of Rhode Island regardless of age, sex, race, occupational status, physical condition, and it shall be the duty of any insurer that issues a Rhode Island qualified group program of health benefits to offer, at the option of the applicant, a group policy or contract providing either (i) the hospital and physicians’ service benefits described in § 42-62-10(c), or (ii) all of the benefits described in § 42-62-10(c), to any employer regardless of age, sex, race, occupational status, or physical condition of any employee, or number of persons employed;
(2) To promote efficient management; and
(3) To reimburse only vendors of health services certified by the director of the department of health.
(b) The provisions of this section shall not apply to health maintenance organizations.
(c) It shall be the duty of vendors of eligible health services to provide those services to insurers and other persons at costs, charges, or rates that are equitable, nondiscriminatory, and in the public interest. In the event that the director of the department of business regulation shall determine that a vendor is discriminating unlawfully against any insurer with respect to costs, charges, or rates, the director shall advise the vendor in writing to cease the discriminatory practices forthwith.
(d) At any hearing conducted pursuant to § 42-62-13, the director of the department of business regulation may disallow any payments made by an insurer to a vendor not certified by the department of health, or to a vendor that has failed to cease discriminatory practices against any insurer after having received a notice from the director of business regulation pursuant to this section.
History of Section.
P.L. 1974, ch. 50, § 1; P.L. 1975, ch. 184, § 1.