2024 -- S 2384

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LC004920

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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

     Introduced By: Senators F. Lombardi, Ciccone, Bissaillon, Britto, and Raptakis

     Date Introduced: February 12, 2024

     Referred To: Senate Health & Human Services

     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:

     27-18-95. Coverage for naturopathy, data collection, and reporting requirements.

     (a) Every individual or group health insurance contract, plan, or policy contract delivered,

issued for delivery, or renewed in this state on or after January 1, 2025, shall:

     (1) Provide coverage for naturopathy performed by an individual licensed under chapter

36.1 of title 5;

     (2) Collect pertinent data pertaining to the coverage and performance of naturopathy

including, but not limited to, data related to: the cost and the average cost to them for enrollees who

treat with naturopathic physicians; the cost and the average cost to them for enrollees who do not

treat with naturopathic physicians; and for enrollees who treat with naturopathic and allopathic

physicians, the number of any claims made by, and services provided to, enrollees for duplicative

treatment; and

     (3) On January 1, 2025, and annually thereafter on January 1 through to January 1, 2028,

the insurer shall submit a report to the speaker of the house, the president of the senate, and the

governor, with respect to the data collected pursuant to this section, which shall include the data

referenced in subsection (a)(2) of this section.

     (4) The provisions of this section shall sunset and expire effective January 2, 2028.

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-87. Coverage for naturopathy, data collection, and reporting requirements.

     (a) Every individual or group health insurance contract, plan, or policy contract delivered,

issued for delivery, or renewed in this state on or after January 1, 2025, shall:

     (1) Provide coverage for naturopathy performed by an individual licensed under chapter

36.1 of title 5;

     (2) Collect pertinent data pertaining to the coverage and performance of naturopathy

including, but not limited to, data related to: the cost and the average cost to them for enrollees who

treat with naturopathic physicians; the cost and the average cost to them for enrollees who do not

treat with naturopathic physicians; and for enrollees who treat with naturopathic and allopathic

physicians, the number of any claims made by, and services provided to, enrollees for duplicative

treatment; and

     (3) On January 1, 2025, and annually thereafter on January 1 through to January 1, 2028,

the insurer shall submit a report to the speaker of the house, the president of the senate, and the

governor, with respect to the data collected pursuant to this section, which shall include the data

referenced above in subsection (a)(2) of this section.

     (4) The provisions of this section shall sunset and expire effective January 2, 2028.

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-83. Coverage for naturopathy, data collection, and reporting requirements.

     (a) Every individual or group health insurance contract, plan, or policy contract delivered,

issued for delivery, or renewed in this state on or after January 1, 2025, shall:

     (1) Provide coverage for naturopathy performed by an individual licensed under chapter

36.1 of title 5;

     (2) Collect pertinent data pertaining to the coverage and performance of naturopathy

including, but not limited to, data related to: the cost and the average cost to them for enrollees who

treat with naturopathic physicians; the cost and the average cost to them for enrollees who do not

treat with naturopathic physicians; and for enrollees who treat with naturopathic and allopathic

physicians, the number of any claims made by, and services provided to, enrollees for duplicative

treatment; and

     (3) On January 1, 2025, and annually thereafter on January 1 through to January 1, 2028,

the insurer shall submit a report to the speaker of the house, the president of the senate, and the

governor, with respect to the data collected pursuant to this section, which shall include the data

referenced in subsection (a)(2) of this section.

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     (4) The provisions of this section shall sunset and expire effective January 2, 2028.

     SECTION 4. Section 27-38.2-1 of the General Laws in Chapter 27-38.2 entitled "Insurance

Coverage for Mental Illness and Substance Use Disorders" is hereby amended to read as follows:

     27-38.2-1. Coverage for treatment of mental health and substance use disorders

Coverage for treatment of mental health and substance use disorders, data collection, and

reporting requirements.

     (a) A group health plan and an individual or group health insurance plan shall provide

coverage for the treatment of mental health and substance use disorders under the same terms and

conditions as that coverage is provided for other illnesses and diseases.

     (b) Coverage for the treatment of mental health and substance use disorders shall not

impose any annual or lifetime dollar limitation.

     (c) Financial requirements and quantitative treatment limitations on coverage for the

treatment of mental health and substance use disorders shall be no more restrictive than the

predominant financial requirements applied to substantially all coverage for medical conditions in

each treatment classification.

     (d) Coverage shall not impose non-quantitative treatment limitations for the treatment of

mental health and substance use disorders unless the processes, strategies, evidentiary standards,

or other factors used in applying the non-quantitative treatment limitation, as written and in

operation, are comparable to, and are applied no more stringently than, the processes, strategies,

evidentiary standards, or other factors used in applying the limitation with respect to

medical/surgical benefits in the classification.

     (e) The following classifications shall be used to apply the coverage requirements of this

chapter: (1) Inpatient, in-network; (2) Inpatient, out-of-network; (3) Outpatient, in-network; (4)

Outpatient, out-of-network; (5) Emergency care; and (6) Prescription drugs.

     (f) Medication-assisted treatment or medication-assisted maintenance services of substance

use disorders, opioid overdoses, and chronic addiction, including methadone, buprenorphine,

naltrexone, or other clinically appropriate medications, is included within the appropriate

classification based on the site of the service.

     (g) Payors shall rely upon the criteria of the American Society of Addiction Medicine when

developing coverage for levels of care for substance use disorder treatment.

     (h) Patients with substance use disorders shall have access to evidence-based, non-opioid

treatment for pain, therefore coverage shall apply to medically necessary chiropractic care and

osteopathic manipulative treatment performed by an individual licensed under § 5-37-2.

     (i) Parity of cost-sharing requirements. Regardless of the professional license of the

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provider of care, if that care is consistent with the provider’s scope of practice and the health plan’s

credentialing and contracting provisions, cost sharing for behavioral health counseling visits and

medication maintenance visits shall be consistent with the cost sharing applied to primary care

office visits.

     (j) Every individual or group health insurance contract, plan, or policy contract delivered,

issued for delivery, or renewed in this state on or after January 1, 2025, shall:

     (1) Provide coverage for naturopathy performed by an individual licensed under chapter

36.1 of title 5;

     (2) Collect pertinent data pertaining to the coverage and performance of naturopathy

including, but not limited to, data related to: the cost and the average cost to them for enrollees who

treat with naturopathic physicians; the cost and the average cost to them for enrollees who do not

treat with naturopathic physicians; and for enrollees who treat with naturopathic and allopathic

physicians the number of any claims made by, and services provided to, enrollees for duplicative

treatment; and

     (3) On January 1, 2025, and annually thereafter on January 1 through to January 1, 2028,

the insurer shall submit a report to the speaker of the house, the president of the senate, and the

governor, with respect to the data collected pursuant to this section, which shall include the data

referenced in subsection (j)(2) of this section.

     (4) The provisions of subsection (j) of this section shall sunset and expire effective January

1, 2028.

     SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-100. Coverage for naturopathy, data collection, and reporting requirements.

     Every individual or group health insurance contract, plan, or policy contract delivered,

issued for delivery, or renewed in this state on or after January 1, 2025, shall:

     (1) Provide coverage for naturopathy performed by an individual licensed under chapter

36.1 of title 5;

     (2) Collect pertinent data pertaining to the coverage and performance of naturopathy

including, but not limited to, data related to: the cost and the average cost to them for enrollees who

treat with naturopathic physicians; the cost and the average cost to them for enrollees who do not

treat with naturopathic physicians; and for enrollees who treat with naturopathic and allopathic

physicians the number of any claims made by, and services provided to, enrollees for duplicative

treatment; and

     (3) On January 1, 2025, and annually thereafter on January 1 through to January 1, 2028,

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the insurer shall submit a report to the speaker of the house, the president of the senate, and the

governor, with respect to the data collected pursuant to this section, which shall include the data

referenced above in subsection (a)(2) of this section.

     (4) The provisions of this section shall sunset and expire effective January 2, 2028.

     SECTION 6. This act shall take effect on January 1, 2025, and shall sunset and expire on

January 2, 2028.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

***

     This act would require health insurance contract plans or policies to provide coverage for

the licensed practice of naturopathy as provided in chapter 36.1 of title 5 effective January 1, 2025,

through to January 1, 2028. This act would also direct the insurer to collect data and file certain

reports regarding this coverage with the speaker of the house, the president of the senate, and the

governor.

     This act would take effect on January 1, 2025 and would sunset and expire on January 2,

2028.

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