H8135

	2026 -- H 8135
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	LC005473
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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 -- ACCIDENT AND SICKNESS INSURANCE POLICIES --
	EQUAL PAY FOR HEALTHCARE PROVIDERS

	Introduced By: Representatives Casimiro, Donovan, Spears, Potter, Alzate, Shallcross Smith, and Hopkins
	Date Introduced: February 27, 2026
	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	27-18-96. Equal pay for healthcare providers.
4	(a) Whenever any policy of health insurance provides for reimbursement for any service
5	which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
6	defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
7	service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
8	for such service, whether it is performed by a physician licensed by the board of medical licensure
9	and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
10	as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
11	professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
12	physician assistant or nurse practitioner.
13	(b) The reimbursement of a service described in subsection (a) of this section that is
14	provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
15	practice shall be in the same amount as the reimbursement paid under the policy to a licensed
16	physician performing the service in the area served.
17	(c) As used in this section, “independent practice” means the provision of healthcare
18	services to patients in a setting in which the licensed physician assistant or the certified nurse

1	practitioner bills insurers for services identified by diagnosis and procedure codes using the
2	physician assistant’s or nurse practitioner’s own name and national provider identifier.
3	(d) This section does not apply to group practice health maintenance organizations that are
4	federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
5	insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
6	provide primary care or mental health services and do not compensate such practitioners on a fee
7	for-service basis.
8	(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
9	comply with this section.
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	27-19-88. Equal pay for healthcare providers.
13	(a) Whenever any policy of health insurance provides for reimbursement for any service
14	which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
15	defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
16	service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
17	for such service, whether it is performed by a physician licensed by the board of medical licensure
18	and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
19	as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
20	professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
21	physician assistant or nurse practitioner.
22	(b) The reimbursement of a service described in subsection (a) of this section that is
23	provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
24	practice shall be in the same amount as the reimbursement paid under the policy to a licensed
25	physician performing the service in the area served.
26	(c) As used in this section, “independent practice” means the provision of healthcare
27	services to patients in a setting in which the licensed physician assistant or the certified nurse
28	practitioner bills insurers for services identified by diagnosis and procedure codes using the
29	physician assistant’s or nurse practitioner’s own name and national provider identifier.
30	(d) This section does not apply to group practice health maintenance organizations that are
31	federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
32	insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
33	provide primary care or mental health services and do not compensate such practitioners on a fee
34	for-service basis.
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1	(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
2	comply with this section.
3	SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
4	Corporations" is hereby amended by adding thereto the following section:
5	27-20-84. Equal pay for healthcare providers.
6	(a) Whenever any policy of health insurance provides for reimbursement for any service
7	which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
8	defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
9	service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
10	for such service, whether it is performed by a physician licensed by the board of medical licensure
11	and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
12	as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
13	professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
14	physician assistant or nurse practitioner.
15	(b) The reimbursement of a service described in subsection (a) of this section that is
16	provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
17	practice shall be in the same amount as the reimbursement paid under the policy to a licensed
18	physician performing the service in the area served.
19	(c) As used in this section, “independent practice” means the provision of healthcare
20	services to patients in a setting in which the licensed physician assistant or the certified nurse
21	practitioner bills insurers for services identified by diagnosis and procedure codes using the
22	physician assistant’s or nurse practitioner’s own name and national provider identifier.
23	(d) This section does not apply to group practice health maintenance organizations that are
24	federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
25	insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
26	provide primary care or mental health services and do not compensate such practitioners on a fee
27	for-service basis.
28	(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
29	comply with this section.
30	SECTION 4. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby
31	amended by adding thereto the following section:
32	40-8-33. Equal pay for healthcare providers.
33	(a) Beginning January 1, 2027, the executive office of health and human services (EOHHS)
34	shall provide for reimbursement for any service which is within the lawful scope of practice of a
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1	duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or
2	dispensing drugs, a primary care or mental health service, provided by a licensed physician, the
3	insured under the policy is entitled to reimbursement for such service, whether it is performed by
4	a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse
5	practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a
6	certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if
7	the service is within the lawful scope of practice of the physician assistant or nurse practitioner.
8	(b) The reimbursement of a service described in subsection (a) of this section that is
9	provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
10	practice shall be in the same amount as the reimbursement paid under the policy to a licensed
11	physician performing the service in the area served.
12	(c) As used in this section, “independent practice” means the provision of healthcare
13	services to patients in a setting in which the licensed physician assistant or the certified nurse
14	practitioner bills insurers for services identified by diagnosis and procedure codes using the
15	physician assistant’s or nurse practitioner’s own name and national provider identifier.
16	(d) The secretary of the EOHHS shall apply to the United States department of health and
17	human services for any amendment to the state Medicaid plan or for any Medicaid waiver as
18	necessary to implement this section. The secretary of the EOHHS shall submit the Medicaid state
19	plan amendment on or before October 1, 2026.
20	SECTION 5. This act shall take effect on January 1, 2027.
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	EXPLANATION
	BY THE LEGISLATIVE COUNCIL
	OF
	A N A C T
	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --
	EQUAL PAY FOR HEALTHCARE PROVIDERS
	***
1	This act would require the state and private health insurers to reimburse claims for
2	healthcare services provided by nurse practitioners and physician assistants at the same amount as
3	the reimbursement paid to a physician performing the service in the area served.
4	This act would take effect on January 1, 2027.
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