2026 -- H 8309 | |
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LC006086 | |
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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 -- FEE SCHEDULE TRANSPARENCY AND FAIR BILLING | |
ACT | |
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Introduced By: Representatives Place, Hopkins, Cotter, Santucci, Shanley, Stewart, | |
Date Introduced: March 18, 2026 | |
Referred To: House Corporations | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended by |
2 | adding thereto the following chapter: |
3 | CHAPTER 84 |
4 | FEE SCHEDULE TRANSPARENCY AND FAIR BILLING ACT |
5 | 27-84-1. Short title. |
6 | This chapter shall be known and may be cited as the “Fee Schedule Transparency and Fair |
7 | Billing Act.” |
8 | 27-84-2. Publication of fee schedules. |
9 | (a) Every insurer shall publish and provide participating physicians, physician practices, |
10 | physician corporations, physician partnerships or any other entity providing medical services, with |
11 | a complete, current fee schedule listing the maximum allowable reimbursement for every covered |
12 | service and procedure code. |
13 | (b) Physicians, physician practices, physician corporations, physician partnerships or any |
14 | other entity providing medical services shall include, but not be limited to, those healthcare |
15 | providers in chapters 18, 19, 20 and 41 of title 27. |
16 | (c) Updates must be provided within thirty (30) days of any change via secure provider |
17 | portals. |
18 | 27-84-3. Fair reimbursement. |
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1 | An insurer shall reimburse any claim submitted at or below the published maximum |
2 | allowable rate in full, without requiring inflated “usual and customary” charges. No reductions, |
3 | bundling restrictions, or penalties shall be applied solely based on the charge amount when it does |
4 | not exceed the published maximum. |
5 | 27-84-4. Insurer – Definition. |
6 | For purposes of this chapter, “insurer” means every nonprofit medical service corporation, |
7 | hospital service corporation, health maintenance organization, or other insurer offering and/or |
8 | insuring health services; the term shall in addition include any entity defined as an insurer under § |
9 | 42-62-4. |
10 | 27-84-5. Enforcement. |
11 | (a) The office of the health insurance commissioner shall oversee compliance and may |
12 | impose penalties of up to twenty-five thousand dollars ($25,000) for each violation of this chapter. |
13 | (b) Annual reports on fee schedule availability and billing disputes shall be published by |
14 | the office of the health insurance commissioner by July 1 of each year. |
15 | SECTION 2. This act shall take effect ninety (90) days after passage. |
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LC006086 | |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO INSURANCE -- FEE SCHEDULE TRANSPARENCY AND FAIR BILLING | |
ACT | |
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1 | This act would require that every insurer providing health coverage insurance provide |
2 | every physician or physician group with a complete fee schedule listing the maximum allowable |
3 | reimbursement for each covered service. |
4 | This act would take effect ninety (90) days after passage. |
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LC006086 | |
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