2012 -- H 7794

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LC01922

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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: Representative Joseph M. McNamara

     Date Introduced: February 28, 2012

     Referred To: House Corporations

It is enacted by the General Assembly as follows:

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     SECTION 1. 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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     27-18-71. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, every policy delivered or issued in this state and

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every individual or group hospital or medical services plan contract delivered or renewed in this

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state on or after October 1, 2012 shall require insurers to reimburse hospitals and all licensed

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health care providers for the entire negotiated payment rate for each service provided by or on

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behalf of the hospital, including, without limitation, deductibles, copayments or any other form of

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patient financial responsibility. Any and all deductibles, copayments or other forms of patient

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financial responsibility established under individual or group hospital or medical services plan

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contracts will be collected from the insured by the insurer unless a hospital or licensed health care

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provider voluntarily agrees to assume such responsibility for the insurer.

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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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     27-19-5.4. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, from and after October 1, 2012 every nonprofit

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hospital service corporation shall reimburse hospitals and all licensed health care providers for

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the entire negotiated payment rate for each service provided by or on behalf of the hospital,

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including, without limitation, deductibles, copayments or any other form of patient financial

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responsibility. Any and all deductibles, copayments or other forms of patient financial

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responsibility established under nonprofit hospital service corporation contracts will be collected

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from the insured by the nonprofit hospital service corporation unless a hospital or licensed

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healthcare worker voluntarily agrees to assume such responsibility for the nonprofit hospital

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service corporation.

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     SECTION 3. 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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     27-20-5.4. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, from and after October 1, 2012 every nonprofit

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medical service corporation shall reimburse hospitals and all licensed health care providers for

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the entire negotiated payment rate for each service provided by or on behalf of the hospital,

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including, without limitation, deductibles, copayments or any other form of patient financial

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responsibility. Any and all deductibles, copayments or other forms of patient financial

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responsibility established under nonprofit medical service corporation contracts will be collected

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from the insured by the nonprofit medical service corporation unless a hospital or licensed health

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care provider voluntarily agrees to assume such responsibility for the nonprofit medical service

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corporation.

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     SECTION 4. Chapter 27-20.1 of the General Laws entitled "Nonprofit Dental Service

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

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     27-20.1-3.1. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, from and after October 1, 2012 every nonprofit

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dental service corporation shall reimburse hospitals and all licensed health care providers for the

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entire negotiated payment rate for each service provided by or on behalf of the hospital,

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including, without limitation, deductibles, copayments or any other form of patient financial

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responsibility. Any and all deductibles, copayments or other forms of patient financial

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responsibility established under nonprofit dental service corporation contracts will be collected

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from the insured by the nonprofit dental service corporation unless a hospital or licensed health

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care provider voluntarily agrees to assume such responsibility for the nonprofit dental service

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corporation.

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     SECTION 5. Chapter 27-20.2 of the General Laws entitled "Nonprofit Optometric

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

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     27-20.2-3.1. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, from and after October 1, 2012 every nonprofit

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optometric service corporation shall reimburse hospitals and all licensed health care providers for

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the entire negotiated payment rate for each service provided by or on behalf of the hospital or

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licensed health care provider, including, without limitation, deductibles, copayments or any other

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form of patient financial responsibility. Any and all deductibles, copayments or other forms of

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patient financial responsibility established under nonprofit optometric service corporation

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contracts will be collected from the insured by the nonprofit optometric service corporation

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unless a hospital or licensed health care provider voluntarily agrees to assume such responsibility

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for the nonprofit optometric service corporation.

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     SECTION 6. 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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     27-41-26.2. Copayment and deductible responsibility. -- Notwithstanding any other

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provision of the general laws to the contrary, from and after October 1, 2012 every health

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maintenance organization shall reimburse hospitals and all licensed health care providers for the

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entire negotiated payment rate for each service provided by or on behalf of the hospital,

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including, without limitation, deductibles, copayments or any other form of patient financial

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responsibility. Any and all deductibles, copayments or other forms of patient financial

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responsibility established under health maintenance organization contracts will be collected from

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the insured by the health maintenance organization unless a hospital or licensed health care

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provider voluntarily agrees to assume such responsibility for the health maintenance organization.

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     SECTION 7. This act shall take effect upon passage.

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LC01922

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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 insurers to reimburse health care providers for entire negotiated

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payment rates including, without limitation, deductibles, copayments and other forms of patient

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financial responsibility with such deductibles and copayments to be, unless otherwise agreed,

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collected from the insured by the insurer.

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     This act would take effect upon passage.

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LC01922

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