2025 -- H 5862 | |
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LC002314 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2025 | |
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A N A C T | |
RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION | |
REVIEW ACT | |
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Introduced By: Representative Joseph J. Solomon | |
Date Introduced: February 28, 2025 | |
Referred To: House Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 27-18.9 of the General Laws entitled "Benefit Determination and |
2 | Utilization Review Act" is hereby amended by adding thereto the following section: |
3 | 27-18.9-16. Medically necessary treatment -- Justification for denial. |
4 | Any healthcare service or procedure authorized by a provider to a patient shall create a |
5 | presumption that the healthcare service or procedure is medically necessary and it shall be the duty |
6 | of the insurance company to provide justification for any denial of such healthcare service or |
7 | procedure. |
8 | SECTION 2. This act shall take effect upon passage. |
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LC002314 | |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION | |
REVIEW ACT | |
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1 | This act would require insurance companies to prove that a healthcare service or procedure |
2 | is not medically necessary. |
3 | This act would take effect upon passage. |
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