2024 -- H 8074 | |
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LC005655 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2024 | |
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A N A C T | |
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES | |
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Introduced By: Representatives Cardillo, Lima, Azzinaro, Noret, Phillips, Serpa, Vella- | |
Date Introduced: March 15, 2024 | |
Referred To: House Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance |
2 | Policies" is hereby amended by adding thereto the following section: |
3 | 27-18-95. Primary care referrals. |
4 | (a) On or after January 1, 2025, every individual or group health insurance contract, plan, |
5 | or policy that is delivered, issued for delivery, prescribed, or renewed in this state shall not require |
6 | a patient to obtain a referral for a specialist from their primary care provider (PCP) in order to |
7 | address their health care needs. |
8 | (b) The insurer shall not require a higher or additional copay or coinsurance coverage after |
9 | the application of the deductible for visiting a specialist without a primary care referral. |
10 | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service |
11 | Corporations" is hereby amended by adding thereto the following section: |
12 | 27-19-87. Primary care referrals. |
13 | (a) On or after January 1, 2025, every individual or group health insurance contract, plan, |
14 | or policy that is delivered, issued for delivery, prescribed, or renewed in this state shall not require |
15 | a patient to obtain a referral for a specialist from their primary care provider (PCP) in order to |
16 | address their health care needs. |
17 | (b) The insurer shall not require a higher or additional copay or coinsurance coverage after |
18 | the application of the deductible for visiting a specialist without a primary care referral. |
19 | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service |
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1 | Corporations" is hereby amended by adding thereto the following section: |
2 | 27-20-83. Primary care referrals. |
3 | (a) On or after January 1, 2025, every individual or group health insurance contract, plan, |
4 | or policy that is delivered, issued for delivery, prescribed, or renewed in this state shall not require |
5 | a patient to obtain a referral for a specialist from their primary care provider (PCP) in order to |
6 | address their health care needs. |
7 | (b) The insurer shall not require a higher or additional copay or coinsurance coverage after |
8 | the application of the deductible for visiting a specialist without a primary care referral. |
9 | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance |
10 | Organizations" is hereby amended by adding thereto the following section: |
11 | 27-41-100. Primary care referrals. |
12 | (a) On or after January 1, 2025, every individual or group health insurance contract, plan, |
13 | or policy that is delivered, issued for delivery, prescribed, or renewed in this state shall not require |
14 | a patient to obtain a referral for a specialist from their primary care provider (PCP) in order to |
15 | address their health care needs. |
16 | (b) The insurer shall not require a higher or additional copay or coinsurance coverage after |
17 | the application of the deductible for visiting a specialist without a primary care referral. |
18 | SECTION 5. This act shall take effect upon passage. |
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LC005655 | |
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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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1 | This act would remove the requirement for a patient to obtain a referral from their primary |
2 | care provider in order to see a specialist, on or after January 1, 2025. |
3 | This act would take effect upon passage. |
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LC005655 | |
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