2021 -- H 5072

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LC000184

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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A N   A C T

RELATING TO INSURANCE -- ACCESSIBLE RESIDENCE MODIFICATIONS

     Introduced By: Representative Joseph M. McNamara

     Date Introduced: January 22, 2021

     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. Coverage for accessible residence modifications.

     (a) Every individual or group hospital or medical expense insurance policy or individual

group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

state on or after July 1, 2022 shall provide coverage for accessible residence modifications when

determined to be medically necessary and ordered by a physician after making a thorough

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

modification the patient would have to move into a long-term care residential facility.

     (b) This section 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; and

     (9) Other limited benefit policies.

     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. Coverage for accessible residence modifications.

     (a) Every individual or group hospital or medical expense insurance policy or individual

group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

state on or after July 1, 2022 shall provide coverage for accessible residence modifications when

determined to be medically necessary and ordered by a physician after making a thorough

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

modification the patient would have to move into a long-term care residential facility.

     (b) This section 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; and

     (9) Other limited benefit policies.

     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. Coverage for accessible residence modifications.

     (a) Every individual or group hospital or medical expense insurance policy or individual

group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

state on or after July 1, 2022 shall provide coverage for accessible residence modifications when

determined to be medically necessary and ordered by a physician after making a thorough

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

modification the patient would have to move into a long-term care residential facility.

     (b) This section 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;

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     (6) Limited benefit health;

     (7) Specified disease indemnity;

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

     (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:

     27-41-90. Coverage for accessible residence modifications.

     (a) Every individual or group hospital or medical expense insurance policy or individual

group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

state on or after July 1, 2022 shall provide coverage for accessible residence modifications when

determined to be medically necessary and ordered by a physician after making a thorough

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

modification the patient would have to move into a long-term care residential facility.

     (b) This section 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; and

     (9) Other limited benefit policies.

     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 -- ACCESSIBLE RESIDENCE MODIFICATIONS

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     This act would require health insurance plans to provide coverage for accessible residence

modifications when those modifications are determined to be medically necessary, but only after a

physician makes a determination that absent the accessible modifications, the patient would have

to move into a long-term care residential facility.

     This act would take effect upon passage.

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