2026 -- S 2379 SUBSTITUTE A

========

LC003650/SUB A

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

____________

A N   A C T

RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH

     Introduced By: Senators Ujifusa, Lawson, Ciccone, Tikoian, Appollonio, DiMario,
Lauria, Valverde, Zurier, and Acosta

     Date Introduced: January 30, 2026

     Referred To: Senate Health & Human Services

     (Dept. of Health)

It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-1-44 of the General Laws in Chapter 23-1 entitled "Department

of Health" is hereby amended to read as follows:

     23-1-44. Routine childhood and adult immunization vaccines.

     (a) The department of health shall include in the department’s immunization program those

vaccines for routine childhood immunization as recommended by the Advisory Committee for

Immunization Practices (ACIP) and the Academy of Pediatrics (AAP) or as determined by the

director of the department of health to be necessary to protect the public health, and for routine

adult immunization as recommended by the ACIP, or as determined by the director of the

department of health to be necessary to protect the public health to the extent permitted by available

funds. The immunization program includes administrative and quality assurance services and the

Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized

information system that is used to manage statewide immunizations, for all persons in Rhode

Island.

     (b) The director of the department of health shall appoint an advisory committee that will

be convened after the ACIP makes a recommendation regarding immunization at the discretion of

the director. The committee will review the ACIP recommendations for the state and director-

initiated proposals for the state; assess the vaccine cost and feasibility; and advise the director of

health and the office of the health insurance commissioner regarding insurers and providers acting

on the ACIP immunization recommendation immunization recommendations or proposals. All

recommendations will be posted on the department of health website. The advisory committee

membership shall include, but not be limited to, a primary care provider, an epidemiologist, a

pharmacist, major insurers, and at the discretion of the director, representatives of the nursing home

industry, and the home healthcare industry and major insurers.

     (c) For the purpose of protecting patients’ information, all personally-identifiable

information obtained pursuant to this section shall be subject to the privacy protections of chapter

37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No.

104-191 (HIPAA), as amended.

     SECTION 2. Section 23-101-2 of the General Laws in Chapter 23-101 entitled "Healthcare

Provider Shield" is hereby amended to read as follows:

     23-101-2. Definitions.

     As used in this chapter, the followings words shall have the following meanings unless the

context clearly indicates otherwise:

     (1) “Aggrieved person” means:

     (i) A person against whom hostile litigation is filed or prosecuted or the legal representative

of a person against whom hostile litigation is filed or prosecuted; or

     (ii) The employer of a person against whom hostile litigation is filed or prosecuted if the

legally protected healthcare activity or aiding and assisting legally protected healthcare activity of

the person that forms the basis of the hostile litigation was performed within the scope of the

person’s employment.

     (2) “Aid and assist legally protected healthcare activity” and “aiding and assisting legally

protected healthcare activity” mean:

     (i) Any act or omission of a person aiding or effectuating or attempting to aid or effectuate

any other person in legally protected healthcare activity; or

     (ii) The provision or administration of, or attempted provision or administration of,

insurance coverage for gender-affirming healthcare services or reproductive healthcare services to

a beneficiary or a dependent of a beneficiary by any insurer, payor, or employer.; or

     (iii) The prescription or administration, dispensing, or provision of, or attempted

administration, dispensing, or provision of, a vaccination pursuant to the routine childhood and

adult immunization vaccine recommendations that are developed under § 23-1-44; or

     (iii)(iv) “Aiding and assisting legally protected healthcare activity” does not include any

conduct that violates Rhode Island law or deviates from the applicable standard of care or that could

form the basis of a civil, criminal, or administrative action under the laws of this state had the

course of conduct that forms the basis for liability occurred entirely within this state.

LC003650/SUB A - Page 2 of 7

     (3) “Foreign judgment” means any judgment or decree of a court of another state.

     (4) “Gender-affirming healthcare services” means all supplies, care, and services of a

medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive,

rehabilitative, or supportive nature, including medication, relating to the treatment of gender

dysphoria and gender incongruence in accordance with the accepted standard of care as defined by

major medical professional organizations and agencies with expertise in the field of gender-

affirming health care, including the Standards of Care for the Health of Transgender and Gender

Diverse People, Version 8, or subsequent version, published by the World Professional Association

for Transgender Health. “Gender-affirming healthcare services” does not include conversion

therapy as defined by § 23-94-2.

     (5) “Healthcare provider” means and shall apply to the following:

     (i) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5;

     (ii) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5;

     (iii) A qualified physician assistant licensed pursuant to chapter 54 of title 5;

     (iv) A genetic counselor licensed pursuant to chapter 92 of title 5;

     (v) A qualified psychologist licensed pursuant to chapter 44 of title 5;

     (vi) A qualified social worker licensed pursuant to chapter 39.1 of title 5;

     (vii) An advanced practice registered nurse, and a certified nurse practitioner, licensed

pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to

chapters 34 and 34.2 of title 5;

     (viii) A certified nurse midwife licensed pursuant to chapter 13 of this title;

     (ix) A licensed clinical mental health counselor or associate, and a licensed marriage and

family therapist or associate, licensed pursuant to chapter 63.2 of title 5;

     (x) An electrologist licensed pursuant to chapter 32 of title 5;

     (xi) A speech-language pathologist licensed pursuant to chapter 48 of title 5;

     (xii) An occupational therapist licensed pursuant to chapter 40.1 of title 5;

     (xiii) A chiropractic physician licensed pursuant to chapter 30 of title 5; and

     (xiv) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter

19.1 of title 5.

     (6) “Hostile litigation” means any litigation or other legal action, including civil, criminal,

or administrative action, to deter, prevent, sanction, or punish any person engaging in legally

protected healthcare activity or aiding and assisting legally protected healthcare activity by:

     (i) Filing or prosecuting any litigation or other legal action in any other state where liability

is based on legally protected healthcare activity or aiding and assisting legally protected healthcare

LC003650/SUB A - Page 3 of 7

activity that occurred in this state, including any action in which liability is based on any theory of

vicarious, joint, or several liability; or

     (ii) Attempting to enforce any order or judgment issued in connection with any litigation

or other legal action under subsection (6)(i) of this section by any party to the action or by any

person acting on behalf of any party to the action.

     (iii) For purposes of this chapter, litigation or other legal action is based on legally protected

healthcare activity or aiding and assisting legally protected healthcare activity that occurred in this

state if any part of any act or omission involved in the course of conduct that forms the basis for

liability in the action occurs or is initiated in this state, whether or not the act or omission is alleged

or included in any pleading or other filing in the lawsuit.

     (7) “Law enforcement agency” means any police department in any city or town or the

state police as defined in the general laws. For purposes of this act, a law enforcement agency may

include any other non-federal entity in the state charged with the enforcement of laws relating to

the custody of detained persons.

     (8) “Legally protected healthcare activity” means:

     (i) The exercise and enjoyment or attempted exercise and enjoyment by any person of the

right secured by this state to gender-affirming healthcare services or reproductive healthcare

services; and

     (ii) The provision or attempted provision of gender-affirming healthcare services or

reproductive healthcare services that are permitted under the laws and regulations of this state and

that are provided in accordance with the applicable standard of care by a person properly licensed

under the laws of this state and physically present in this state, regardless of whether the patient is

located in this state or whether the person is licensed in the state where the patient is located at the

time the services are rendered.; and

     (iii) The provision or attempted provision of a routine childhood or adult immunization

vaccine under § 23-1-44.

     (iii)(iv) “Legally protected healthcare activity” does not include any conduct that could

form the basis of a civil, criminal, or administrative action under the laws of this state had the

course of conduct that forms the basis for liability occurred entirely within this state and/or in

violation of Rhode Island law.

     (9) “Reproductive healthcare services” means all supplies, care, and services of a medical,

behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive,

rehabilitative, or supportive nature, including medication, relating to pregnancy, contraception,

assisted reproduction, pregnancy loss management, or the termination of a pregnancy in accordance

LC003650/SUB A - Page 4 of 7

with the applicable standard of care as defined by major medical professional organizations and

agencies with expertise in the field of reproductive health care.

     (10) "Routine childhood and adult immunization vaccine recommendations" means

vaccine recommendations as determined by the director of the department of health to be necessary

to protect the public health under § 23-1-44.

     (10)(11) “State” means a state of the United States, the District of Columbia, Puerto Rico,

the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of

the United States. The term “this state” refers to the state of Rhode Island.

     SECTION 3. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance

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

     27-18-96. Coverage for vaccinations.

     Every individual or group medical service contract or every individual or group hospital or

medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state

on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations

recommended by the Rhode Island department of health (RIDOH).

     SECTION 4. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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

     27-19-88. Coverage for vaccinations.

     Every individual or group medical service contract or every individual or group hospital or

medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state

on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations

recommended by the Rhode Island department of health (RIDOH).

     SECTION 5. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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

     27-20-84. Coverage for vaccinations.

     Every individual or group medical service contract or every individual or group hospital or

medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state

on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations

recommended by the Rhode Island department of health (RIDOH).

     SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance

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

     27-41-101. Coverage for vaccinations.

     Every individual or group medical service contract or every individual or group hospital or

medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state

LC003650/SUB A - Page 5 of 7

on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations

recommended by the Rhode Island department of health (RIDOH).

     SECTION 7. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby

amended by adding thereto the following section:

     40-8-33. Coverage for vaccinations.

     Commencing January 1, 2027, the medical assistance program shall provide coverage,

without cost-sharing, for all vaccinations recommended by the Rhode Island department of health

(RIDOH). This recommendation shall apply to all Medicaid beneficiaries, whether enrolled in fee-

for-service or managed care, to the extent permitted under federal law.

     SECTION 8. Chapter 40-8.5 of the General Laws entitled "Health Care for Elderly and

Disabled Residents Act" is hereby amended by adding thereto the following section:

     40-8.5-1.2. Coverage for vaccinations.

     (a) As used herein, "managed care systems" is defined as systems that: integrate an efficient

financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate

care and deter unnecessary services; and place emphasis on preventive and primary care. For

purposes of this section, managed care systems may also be defined to include a primary care case-

management model, community health teams, and/or other such arrangements that meet standards

established by the executive office and serve the purposes of this section. Managed care systems

may also include services and supports that optimize the health and independence of beneficiaries

who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title (“long-

term care service reform for Medicaid eligible individuals”) or to be at risk for the care under the

applicable federal state plan or waiver authorities and the rules and regulations promulgated by the

executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance

may be provided such services through an entity certified by, or in a contractual arrangement with,

the executive office or, as deemed appropriate, exempt from mandatory managed care in

accordance with rules and regulations promulgated by the executive office.

     (b) Commencing January 1, 2027, any Medicaid managed care organizations under

contract with the executive office of health and human services shall provide coverage, without

cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH),

to the extent permitted under federal law.

     SECTION 9. Chapter 36-12 of the General Laws entitled "Insurance Benefits" is hereby

amended by adding thereto the following section:

     36-12-2.1.1. Coverage for vaccinations.

     Commencing January 1, 2027, the director of administration shall administer health benefit

LC003650/SUB A - Page 6 of 7

programs for state employees and retirees, and shall ensure that coverage is provided, without cost-

sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

     SECTION 10. Severability.

     If any section of this act or its application to any person or circumstance is held invalid, the

invalidity shall not affect other sections or applications of the act that can be given effect without

the invalid section or application, and to this end the sections of this act are declared severable.

     SECTION 11. This act shall take effect upon passage.

========

LC003650/SUB A

========

LC003650/SUB A - Page 7 of 7

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH

***

     Commencing January 1, 2027, this act would mandate insurers provide health insurance

coverage without cost-share requirements for vaccinations recommended by the state department

of health and would mandate the coverage for the medical assistance program and managed care

organizations.

     This act would take effect upon passage.

========

LC003650/SUB A

========

LC003650/SUB A - Page 8 of 7