2001 -- S 0750
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LC01718
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2001
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A N A C T
RELATING TO HEALTH INSURANCE
It is enacted by the General Assembly as follows:
SECTION 1. Chapter 23-17.13 of the General Laws entitled "Health Care Accessibility and Quality Assurance Act" is hereby amended by adding thereto the following section:
23-17.13-6. Regulations regarding selective and/or exclusive contracts. -- (a) The director shall issue regulations on or before January 1, 2001, after receiving input from the department of business regulation, the department of the attorney general, and the general public. The regulations shall provide standards for evaluating, reviewing and approving selective and/or exclusive contracts, which include, but are not limited to, capitation and risk sharing arrangements. Such regulations shall protect the interest of patients and the community and shall require consideration of the impact such arrangements have on the following:
(1)Access to care for insured, underinsured and uninsured members of the community;
(2) The ability of health care providers in this state to continue to provide free and uncompensated care;
(3) Quality and reliability of health services;
(4) Continuity of health services through employees and contracted networks of providers and health systems;
(5) Local employment;
(6) Maintenance of community benefits and public good;
(7) Complete and sound actuarial information evidencing viability of proposal;
(8) Prior to January 1, 2001, or the date on which the department of health promulgates the aforesaid regulations, whichever occurs first, the director of the department of health shall not certify a health plan or approve a material modification to such a plan or product or method of selecting providers for such plan or product, to the extent such plan or modification involves selective and/or exclusive contracting, which include, but are not limited to, capitation or risk sharing arrangements. Further, to ensure the completeness of provider responses, prior to January 1, 2001, or the date on which the regulations are promulgated, whichever occurs first, no health plan shall accept a response to a current request for proposal or issue any future request for proposal or similar vehicle involving selective and/or exclusive arrangements, which include, but are not limited to, capitation or risk sharing arrangements, as a component of such product.
The provisions of this section shall not apply to any arrangement for the provision of health care which is in effect on or before the effective date of this act, and which utilizes selective and/or exclusive contracting, or any future renewal of such arrangement.
SECTION 2. This act shall take effect upon passage.
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LC01718
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HEALTH INSURANCE
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This act would require the director of the department of health to promulgate rules and regulations to govern the review and evaluation of selective and exclusive health care insurance contracts.
This act would take effect upon passage.