2026 -- H 7946

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LC005720

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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A N   A C T

RELATING TO INSURANCE -- THE PROTECT MENTAL HEALTH ACT

     Introduced By: Representatives Tanzi, Kislak, McGaw, Alzate, Spears, Speakman,
Donovan, Cruz, Stewart, and Hull

     Date Introduced: February 27, 2026

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended by

adding thereto the following chapter:

CHAPTER 38.3

THE PROTECT MENTAL HEALTH ACT

     27-38.3-1. Parity compliance and meaningful coverage.

     (a) If a health plan provides coverage for mental health and substance use disorder services,

any cost-sharing requirements for mental health and substance use disorder services and any

treatment limitations, including quantitative treatment limitations and nonquantitative treatment

limitations, related to mental health and substance use disorder services shall comply with the

requirements in the provisions of Requirements Related to the Mental Health Parity and Addiction

Equity Act, 89 Fed. Reg. 77586 (Sept. 23, 2024).

     (b)(1) Each health insurer shall collect and evaluate relevant data, in connection with its

comparative analyses, in a manner reasonably designed to assess, for each nonquantitative

treatment limitation and within each classification of benefits, the impact of the nonquantitative

treatment limitation on relevant outcomes related to access to mental health benefits and substance

use disorder benefits as compared to medical and surgical benefits. With respect to nonquantitative

treatment limitations related to network adequacy and composition, the health insurer shall collect

and evaluate relevant data in a manner reasonably designed to assess the aggregate impact of all

such nonquantitative treatment limitations on access to mental health benefits and substance use

disorder benefits as compared to medical and surgical benefits within each classification of

benefits.

     (2) If the relevant data evaluated under this subsection indicate that a nonquantitative

treatment limitation contributes to material differences in access to mental health benefits or

substance use disorder benefits as compared to medical and surgical benefits within a classification

of benefits, such differences shall be considered a strong indicator of noncompliance with the

federal Mental Health Parity and Addiction Equity Act of 2008 and may subject the health insurer

to enforcement action pursuant to this title, and the health insurer shall submit to the commissioner

documentation of reasonable actions that have been or are being taken to address the material

differences and to ensure compliance, in operation, with parity requirements within fifteen (15)

working days of a request from the commissioner.

     (c) A health insurer shall, as part of the comparative analyses required pursuant to 42

U.S.C. § 300gg-26(8) and this section, demonstrate that none of the information, evidence, sources,

or standards on which a factor or evidentiary standard is based are biased or not objective in a

manner that discriminates against mental health benefits or substance use disorder benefits as

compared to medical and surgical benefits.

     (d) An insurer providing coverage pursuant to this section for mental health benefits and

substance use disorder benefits in any classification of benefits shall provide meaningful benefits

for such mental health benefits and substance use disorder benefits in every classification in which

medical and surgical benefits are provided. For purposes of this subsection, whether benefits are

meaningful shall be determined in comparison to the medical and surgical benefits provided in the

same classification and shall require, at a minimum, coverage of benefits for that mental health

benefit or substance use disorder benefit in each classification in which the insurer provides benefits

for one or more medical and surgical benefits. An insurer does not provide meaningful benefits

under this subsection unless it provides benefits for a core treatment for that mental health benefit

or substance use disorder benefit in each classification in which the insurer provides benefits for a

core treatment for one or more medical and surgical benefits. If there is no core treatment for a

covered mental health benefit or substance use disorder benefit with respect to a classification, the

insurer shall not be required to provide benefits for a core treatment in that classification but shall

provide benefits for such mental health benefit or substance use disorder benefit in every

classification in which medical and surgical benefits are provided. For purposes of this subsection,

“core treatment” means a standard treatment or course of treatment, therapy, service, or

intervention indicated by generally accepted standards of mental health or substance use disorder

care.

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     27-38.3-2. Relation to other mental health coverage laws.

     The requirements of this chapter are in addition to, and shall not be construed to limit or

reduce, the obligations of health insurers under chapter 38.2 of this title or any other provision of

state or federal law governing coverage of mental health or substance use disorder services.

     27-38.3-3. Severability.

     If any provision of this chapter or the application thereof to any person or circumstance is

held invalid, such invalidity shall not affect the other provisions or applications of the chapter which

can be given effect without the invalid provision or application, and to this end the provisions of

this chapter are declared to be severable.

     SECTION 2. 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 -- THE PROTECT MENTAL HEALTH ACT

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     This act would require health insurers to comply with federal mental health parity laws,

prevent discriminatory treatment limits, and ensure meaningful mental health and substance use

coverage in all benefit classifications.

     This act would take effect upon passage.

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