2025 -- S 0263 SUBSTITUTE A

========

LC001160/SUB A

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

____________

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     

     Introduced By: Senators DiMario, Lauria, Urso, Appollonio, Valverde, Bissaillon,
Lawson, Murray, Britto, and Ujifusa

     Date Introduced: February 13, 2025

     Referred To: Senate 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

     27-18-95. Acute mental health crisis mobile response and stabilization services.

4

     (a) As used in this section “Mobile response and stabilization services” means a behavioral

5

health crisis intervention system providing immediate de-escalation, stabilization services, and

6

follow-up care, provided by a certified provider. These services are delivered to provide rapid

7

response to, assessment of, and early intervention for a child or youth eighteen (18) years of age

8

and younger experiencing an acute mental health crisis. Symptoms might include, but are not

9

limited to:

10

     (1) Aggression;

11

     (2) Self-injury;

12

     (3) Trauma;

13

     (4) Acute depression/anxiety;

14

     (5) Challenges at school; Suicidal or homicidal thoughts/behaviors; and

15

     (6) Extreme parent/child conflict.

16

     Mobile response and stabilization services are provided by “certified providers” meaning

17

licensed behavioral health organizations providing outpatient services, which have demonstrated

18

expertise in delivering child-specific mobile response and stabilization services, and have obtained

19

relevant state licensure or certification.

 

1

     (b) Every individual or group health insurance contract, or every individual or group

2

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

3

or renewed in this state on or after January 1, 2026, shall provide coverage for mobile response and

4

stabilization services, consistent with the core components of the mobile crisis model, and in

5

accordance with the insurer’s existing reimbursement, credentialing, and contracting processes,

6

provided any utilization review processes do not limit timely access or fidelity to the model.

7

     (c) This section shall not apply to insurance coverage providing benefits for:

8

     (1) Hospital confinement indemnity;

9

     (2) Disability income;

10

     (3) Accident only;

11

     (4) Long-term care;

12

     (5) Medicare supplement;

13

     (6) Limited benefit health;

14

     (7) Specified disease indemnity;

15

     (8) Sickness or bodily injury or death by accident or both; and

16

     (9) Other limited benefit policies.

17

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

18

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

19

     27-19-87. Acute mental health crisis mobile response and stabilization services.

20

     (a) As used in this section “Mobile response and stabilization services” means a behavioral

21

health crisis intervention system providing immediate de-escalation, stabilization services, and

22

follow-up care, provided by a certified provider. These services are delivered to provide rapid

23

response to, assessment of, and early intervention for a child or youth eighteen (18) years of age

24

and younger experiencing an acute mental health crisis. Symptoms might include, but are not

25

limited to:

26

     (1) Aggression;

27

     (2) Self-injury;

28

     (3) Trauma;

29

     (4) Acute depression/anxiety;

30

     (5) Challenges at school; Suicidal or homicidal thoughts/behaviors; and

31

     (6) Extreme parent/child conflict.

32

     Mobile response and stabilization services are provided by “certified providers” meaning

33

licensed behavioral health organizations providing outpatient services, which have demonstrated

34

expertise in delivering child-specific mobile response and stabilization services, and have obtained

 

LC001160/SUB A - Page 2 of 5

1

relevant state licensure or certification.

2

     (b) Every individual or group health insurance contract, or every individual or group

3

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

4

or renewed in this state on or after January 1, 2026, shall provide coverage for mobile response and

5

stabilization services, consistent with the core components of the mobile crisis model, and in

6

accordance with the insurer’s existing reimbursement, credentialing, and contracting processes,

7

provided any utilization review processes do not limit timely access or fidelity to the model.

8

     (c) This section shall not apply to insurance coverage providing benefits for:

9

     (1) Hospital confinement indemnity;

10

     (2) Disability income;

11

     (3) Accident only;

12

     (4) Long-term care;

13

     (5) Medicare supplement;

14

     (6) Limited benefit health;

15

     (7) Specified disease indemnity;

16

     (8) Sickness or bodily injury or death by accident or both; and

17

     (9) Other limited benefit policies.

18

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

19

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

20

     27-20-83. Acute mental health crisis mobile response and stabilization services.

21

     (a) As used in this section “Mobile response and stabilization services” means a behavioral

22

health crisis intervention system providing immediate de-escalation, stabilization services, and

23

follow-up care, provided by a certified provider. These services are delivered to provide rapid

24

response to, assessment of, and early intervention for a child or youth eighteen (18) years of age

25

and younger experiencing an acute mental health crisis. Symptoms might include, but are not

26

limited to:

27

     (1) Aggression;

28

     (2) Self-injury;

29

     (3) Trauma;

30

     (4) Acute depression/anxiety;

31

     (5) Challenges at school; Suicidal or homicidal thoughts/behaviors; and

32

     (6) Extreme parent/child conflict.

33

     Mobile response and stabilization services are provided by “certified providers” meaning

34

licensed behavioral health organizations providing outpatient services, which have demonstrated

 

LC001160/SUB A - Page 3 of 5

1

expertise in delivering child-specific mobile response and stabilization services, and have obtained

2

relevant state licensure or certification.

3

     (b) Every individual or group health insurance contract, or every individual or group

4

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

5

or renewed in this state on or after January 1, 2026, shall provide coverage for mobile response and

6

stabilization services, consistent with the core components of the mobile crisis model, and in

7

accordance with the insurer’s existing reimbursement, credentialing, and contracting processes,

8

provided any utilization review processes do not limit timely access or fidelity to the model.

9

     (c) This section shall not apply to insurance coverage providing benefits for:

10

     (1) Hospital confinement indemnity;

11

     (2) Disability income;

12

     (3) Accident only;

13

     (4) Long-term care;

14

     (5) Medicare supplement;

15

     (6) Limited benefit health;

16

     (7) Specified disease indemnity;

17

     (8) Sickness or bodily injury or death by accident or both; and

18

     (9) Other limited benefit policies.

19

     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

20

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

21

     27-41-100. Acute mental health crisis mobile response and stabilization services.

22

     (a) As used in this section “Mobile response and stabilization services” means a behavioral

23

health crisis intervention system providing immediate de-escalation, stabilization services, and

24

follow-up care, provided by a certified provider. These services are delivered to provide rapid

25

response to, assessment of, and early intervention for a child or youth eighteen (18) years of age

26

and younger experiencing an acute mental health crisis. Symptoms might include, but are not

27

limited to:

28

     (1) Aggression;

29

     (2) Self-injury;

30

     (3) Trauma;

31

     (4) Acute depression/anxiety;

32

     (5) Challenges at school; Suicidal or homicidal thoughts/behaviors; and

33

     (6) Extreme parent/child conflict.

34

     Mobile response and stabilization services are provided by “certified providers” meaning

 

LC001160/SUB A - Page 4 of 5

1

licensed behavioral health organizations providing outpatient services, which have demonstrated

2

expertise in delivering child-specific mobile response and stabilization services, and have obtained

3

relevant state licensure or certification.

4

     (b) Every individual or group health insurance contract, or every individual or group

5

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

6

or renewed in this state on or after January 1, 2026, shall provide coverage for mobile response and

7

stabilization services, consistent with the core components of the mobile crisis model, and in

8

accordance with the insurer’s existing reimbursement, credentialing, and contracting processes,

9

provided any utilization review processes do not limit timely access or fidelity to the model.

10

     (c) This section shall not apply to insurance coverage providing benefits for:

11

     (1) Hospital confinement indemnity;

12

     (2) Disability income;

13

     (3) Accident only;

14

     (4) Long-term care;

15

     (5) Medicare supplement;

16

     (6) Limited benefit health;

17

     (7) Specified disease indemnity;

18

     (8) Sickness or bodily injury or death by accident or both; and

19

     (9) Other limited benefit policies.

20

     SECTION 5. This act shall take effect on January 1, 2026.

========

LC001160/SUB A

========

 

LC001160/SUB A - Page 5 of 5

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

***

1

     This act would require coverage for acute mental health crisis mobile response and

2

stabilization services to eligible individuals enrolled as plan beneficiaries.

3

     This act would take effect on January 1, 2026.

========

LC001160/SUB A

========

 

LC001160/SUB A - Page 6 of 5