S2409

	2018 -- S 2409
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	LC004523
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	STATE OF RHODE ISLAND
	IN GENERAL ASSEMBLY
	JANUARY SESSION, A.D. 2018
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	A N A C T
	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

	Introduced By: Senators DiPalma, Pearson, Euer, Lombardo, and Miller
	Date Introduced: February 15, 2018
	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
2	Insurance Policies" is hereby amended by adding thereto the following section:
3	27-18-48.2. Prospective reimbursement - State contracts.
4	Any contract between the state of Rhode Island and any health insurance carrier, as
5	defined under chapters 18, 19, 20, and 41 of title 27, shall require the health insurance carrier to
6	pay a state-licensed facility that provides mental health, substance abuse treatment and/or
7	prevention services on a prospective basis. Payment on a prospective basis shall require payment
8	by the health insurance carrier on the first business day of each month with each payment amount
9	equal to the average monthly payment during the immediately preceding calendar year. The
10	facility and the health insurance carrier shall undertake a reconciliation within thirty (30) days of
11	the close of each calendar year with any overpayment repaid by the facility or underpayment paid
12	by the health insurance carrier within ninety (90) days of the close of the calendar year.
13	SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
14	Corporations" is hereby amended by adding thereto the following section:
15	27-19-40.2. Prospective reimbursement - State contracts.
16	Any contract between the state of Rhode Island and any health insurance carrier, as
17	defined under chapters 18, 19, 20, and 41 of title 27, shall require the health insurance carrier to
18	pay a state-licensed facility that provides mental health, substance abuse treatment and/or
19	prevention services on a prospective basis. Payment on a prospective basis shall require payment

1	by the health insurance carrier on the first business day of each month with each payment amount
2	equal to the average monthly payment during the immediately preceding calendar year. The
3	facility and the health insurance carrier shall undertake a reconciliation within thirty (30) days of
4	the close of each calendar year with any overpayment repaid by the facility or underpayment paid
5	by the health insurance carrier within ninety (90) days of the close of the calendar year.
6	SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
7	Corporations" is hereby amended by adding thereto the following section:
8	27-20-35.2. Prospective reimbursement - State contracts.
9	Any contract between the state of Rhode Island and any health insurance carrier, as
10	defined under chapters 18, 19, 20, and 41 of title 27, shall require the health insurance carrier to
11	pay a state-licensed facility that provides mental health, substance abuse treatment and/or
12	prevention services on a prospective basis. Payment on a prospective basis shall require payment
13	by the health insurance carrier on the first business day of each month with each payment amount
14	equal to the average monthly payment during the immediately preceding calendar year. The
15	facility and the health insurance carrier shall undertake a reconciliation within thirty (30) days of
16	the close of each calendar year with any overpayment repaid by the facility or underpayment paid
17	by the health insurance carrier within ninety (90) days of the close of the calendar year.
18	SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance
19	Organizations" is hereby amended by adding thereto the following section:
20	27-41-49.2. Prospective reimbursement - State contracts.
21	Any contract between the state of Rhode Island and any health insurance carrier, as
22	defined under chapters 18, 19, 20, and 41 of title 27, shall require the health insurance carrier to
23	pay a state-licensed facility that provides mental health, substance abuse treatment and/or
24	prevention services on a prospective basis. Payment on a prospective basis shall require payment
25	by the health insurance carrier on the first business day of each month with each payment amount
26	equal to the average monthly payment during the immediately preceding calendar year. The
27	facility and the health insurance carrier shall undertake a reconciliation within thirty (30) days of
28	the close of each calendar year with any overpayment repaid by the facility or underpayment paid
29	by the health insurance carrier within ninety (90) days of the close of the calendar year.
30	SECTION 5. This act shall take effect upon passage.
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	EXPLANATION
	BY THE LEGISLATIVE COUNCIL
	OF
	A N A C T
	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
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1	This act would require prospective reimbursement for state-licensed facilities providing
2	mental health, substance abuse treatment and/or prevention services with an annual reconciliation
3	for any underpayment or overpayment.
4	This act would take effect upon passage.
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