2012 -- H 7687

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LC01431

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

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A N A C T

RELATING TO INSURANCE

     Introduced By: Representatives Tanzi, Naughton, Cimini, Serpa, and Keable

     Date Introduced: February 16, 2012

     Referred To: House Corporations

It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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

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     27-20-65. Primary care provider designation requirement. – Every individual or

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group health insurance contract, or every individual or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2013, shall require that the subscriber and each dependent designate a

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participating primary care provider and the insurer shall collect the designation from the insured.

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Designation of a primary care provider shall not be a condition of enrollment and failure to

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designate a primary care provider shall not constitute grounds for cancellation of coverage. For

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purposes of this section, “primary care provider” means the physician, practice or other medical

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provider considered by the insured to be his or her usual source of medical care.

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

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

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     27-19-69. Primary care provider designation requirement. – Every individual or

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group health insurance contract, or every individual or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2013, shall require that the subscriber and each dependent designate a

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participating primary care provider and the insurer shall collect the designation from the insured.

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Designation of a primary care provider shall not be a condition of enrollment and failure to

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designate a primary care provider shall not constitute grounds for cancellation of coverage. For

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purposes of this section, “primary care provider” means the physician, practice or other medical

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provider considered by the insured to be his or her usual source of medical care.

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

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

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     27-18-78. Primary care provider designation requirement. – (a) Every individual or

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group health insurance contract, or every individual or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2013, shall require that the subscriber and each dependent designate a

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participating primary care provider and the insurer shall collect the designation from the insured.

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Designation of a primary care provider shall not be a condition of enrollment and failure to

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designate a primary care provider shall not constitute grounds for cancellation of coverage. For

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purposes of this section, “primary care provider” means the physician, practice or other medical

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provider considered by the insured to be his or her usual source of medical care.

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     (b) Requirements for designating a primary care provider enumerated in subsection (a)

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shall not apply to insurance coverage providing benefits for:

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     (1) Hospital confinement indemnity;

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     (2) Disability income;

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     (3) Accident only;

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     (4) Long-term care;

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     (5) Medicare supplement;

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     (6) Limited benefit health;

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     (7) Specified disease indemnity;

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

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     (9) Other limited benefit policies.

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

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

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     27-41-82. Primary care provider designation requirement. -- Every individual or

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group health insurance contract, or every individual or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2013, shall require that the subscriber and each dependent designate a

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participating primary care provider and the insurer shall collect the designation from the insured.

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Designation of a primary care provider shall not be a condition of enrollment and failure to

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designate a primary care provider shall not constitute grounds for cancellation of coverage. For

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purposes of this section, “primary care provider” means the physician, practice or other medical

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provider considered by the insured to be his or her usual source of medical care.

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     SECTION 5. The health insurance commissioner is authorized to promulgate regulations

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to implement this act.

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     SECTION 6. This act shall take effect on January 1, 2013.

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LC01431

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE

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     This act would require an insured to designate a participating primary care provider.

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     This act would take effect on January 1, 2013.

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LC01431

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