2022 -- H 7880

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LC005279

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Representatives Tanzi, Felix, McGaw, Ajello, Batista, Donovan, Ranglin-
Vassell, Shallcross Smith, and Cortvriend

     Date Introduced: March 04, 2022

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-18-52 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

     27-18-52. Genetic testing.

     (a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans and

providers shall be prohibited from releasing genetic information without prior written authorization

of the individual. Written authorization shall be required for each disclosure and include to whom

the disclosure is being made. An exception shall exist for those participating in research settings

governed by the Federal Policy for the Protection of Human Research Subjects (also known as "The

Common Rule"). Tests conducted purely for research are excluded from the definition, as are tests

for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

     (b) No individual or group health insurance contract, plan, or policy delivered, issued for

delivery, or renewed in this state which provides health insurance medical coverage that includes

coverage for physician services in a physician's office, and every policy which provides major

medical or similar comprehensive-type coverage excluding disability income, long term care and

insurance supplemental policies which only provide coverage for specified diseases or other

supplemental policies, shall:

     (1) Use a genetic test or request for genetic tests or the results of a genetic test to reject,

deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or affect

a group or an individual health insurance policy, contract, or plan;

     (2) Request or require a genetic test for the purpose of determining whether or not to issue

or renew an individual's health benefits coverage, to set reimbursement/co-pay levels or determine

covered benefits and services;

     (3) Release the results of a genetic test without the prior written authorization of the

individual from whom the test was obtained, except in a format whereby individual identifiers are

removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient

of information pursuant to this section may use or disclose this information solely to carry out the

purpose for which the information was disclosed. Authorization shall be required for each

redisclosure; an exception shall exist for participating in research settings governed by the Federal

Policy for the Protection of Human Research Subjects (also known as "The Common Rule").

     (4) Request or require information as to whether an individual has ever had a genetic test,

or participated in genetic testing of any kind, whether for clinical or research purposes.

     (c) For the purposes of this section, "genetic testing" is the analysis of an individual's DNA,

RNA, chromosomes, proteins and certain metabolites in order to detect heritable disease-related

genotypes, mutations, phenotypes or karyotypes for clinical purposes. Those purposes include

predicting risk of disease, identifying carriers, establishing prenatal and clinical diagnosis or

prognosis. Prenatal, newborn and carrier screening, as well as testing in high risk families may be

included provided there is an approved release by a parent or guardian. Tests for metabolites are

covered only when they are undertaken with high probability that an excess of deficiency of the

metabolite indicates the presence of heritable mutations in single genes. "Genetic testing" does not

mean routine physical measurement, a routine chemical, blood, or urine analysis or a test for drugs

or for HIV infections.

     (d) For the purposes of this section, "genetic testing" includes at-home genetic test kits.

     SECTION 2. Section 27-19-44 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

     27-19-44. Genetic testing.

     (a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans and

providers shall be prohibited from releasing genetic information without prior written authorization

of the individual. Written authorization shall be required for each disclosure and include to whom

the disclosure is being made. An exception shall exist for those participating in research settings

governed by the federal policy for the protection of human research subjects (also known as "The

Common Rule"). Tests conducted purely for research are excluded from the definition, as are tests

for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

     (b) No nonprofit health service corporation subject to the provisions of this chapter shall:

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     (1) Use a genetic test or request for a genetic test or the results of a genetic test or other

genetic information to reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the

terms or conditions of, or affect a group or an individual's health insurance policy, contract, or plan;

     (2) Request or require a genetic test for the purpose of determining whether or not to issue

or renew a group, individual health benefits coverage to set reimbursement/co-pay levels or

determine covered benefits and services;

     (3) Release the results of a genetic test without the prior written authorization of the

individual from whom the test was obtained, except in a format by which individual identifiers are

removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient

of information pursuant to this section may use or disclose the information solely to carry out the

purpose for which the information was disclosed. Authorization shall be required for each

redisclosure. An exception shall exist for participation in research settings governed by the federal

policy for the protection of human research subjects (also known as "The Common Rule");

     (4) Request or require information as to whether an individual has ever had a genetic test,

or participated in genetic testing of any kind, whether for clinical or research purposes.

     (c) For the purposes of this section, "genetic testing" is the analysis of an individual's DNA,

RNA, chromosomes, proteins and certain metabolites in order to detect heritable disease-related

genotypes, mutations, phenotypes or karyotypes for clinical purposes. These purposes include

predicating risk of disease, identifying carriers, establishing prenatal and clinical diagnosis or

prognosis. Prenatal, newborn and carrier screening, as well as testing in high risk families may be

included provided there is an approved release by a parent or guardian. Tests for metabolites are

covered only when they are undertaken with high probability that an excess of deficiency of the

metabolite indicates the presence of heritable mutations in single genes. "Genetic testing" does not

mean routine physical measurement, a routine chemical, blood, or urine analysis, or a test for drugs

or for HIV infection.

     (d) For the purposes of this section, "genetic testing" includes at-home genetic test kits.

     SECTION 3. Section 27-20-39 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

     27-20-39. Genetic testing.

     (a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans and

providers shall be prohibited from releasing genetic information without prior written authorization

of the individual. Written authorization shall be required for each disclosure and include to whom

the disclosure is being made. An exception shall exist for those participating in research settings

governed by the federal policy for the protection of human research subjects (also known as "The

LC005279 - Page 3 of 7

Common Rule"). Tests conducted purely for research are excluded from the definition, as are tests

for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

     (b) No nonprofit health insurer subject to the provisions of this chapter shall:

     (1) Use a genetic test or request for a genetic test or the results of a genetic test to reject,

deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or affect

a group or individual's health insurance policy, contract, or plan;

     (2) Request or require a genetic test for the purpose of determining whether or not to issue

or renew health benefits coverage, to set reimbursement/co-pay levels or determine covered

benefits and services;

     (3) Release the results of a genetic test without the prior written authorization of the

individual from whom the test was obtained, except in a format by which individual identifiers are

removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient

of information pursuant to this section may use or disclose the information solely to carry out the

purpose for which the information was disclosed. Authorization shall be required for each

redisclosure. An exception shall exist for participation in research settings governed by the federal

policy for the protection of human research subjects (also known as "The Common Rule"); or

     (4) Request or require information as to whether an individual has ever had a genetic test,

or participated in genetic testing of any kind, whether for clinical or research purposes.

     (c) For the purposes of this section, "genetic testing" is the analysis of an individual's DNA,

RNA, chromosomes, proteins and certain metabolites in order to detect heritable disease-related

genotypes, mutations, phenotypes or karyotypes for clinical purposes. Those purposes include

predicting risk of disease, identifying carriers, establishing prenatal and clinical diagnosis or

prognosis. Prenatal, newborn and carrier screening, as well as testing in high risk families may be

included provided there is an approved release by a parent or guardian. Tests for metabolites are

covered only when they are undertaken with high probability that an excess of deficiency of the

metabolite indicates the presence of heritable mutations in single genes. "Genetic testing" does not

mean routine physical measurement, a routine chemical, blood, or urine analysis or a test for drugs

or for HIV infections.

     (d) For the purposes of this section, "genetic testing" includes at-home genetic test kits.

     SECTION 4. Section 27-41-53 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

     27-41-53. Genetic testing.

     (a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans and

providers shall be prohibited from releasing genetic information without prior written authorization

LC005279 - Page 4 of 7

of the individual. Written authorization shall be required for each disclosure and include to whom

the disclosure is being made. An exception shall exist for those participating in research settings

governed by the federal policy for the protection of human research subjects (also known as "The

Common Rule"). Tests conducted purely for research are excluded from the definition, as are tests

for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

     (b) No health maintenance organization subject to the provisions of this chapter shall:

     (1) Use a genetic test or request for genetic test the results of a genetic test to reject, deny,

limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or affect a

group or an individual's health insurance policy contract, or plan;

     (2) Request or require a genetic test for the purpose of determining whether or not to issue

or renew an individual's health benefits coverage, to set reimbursement/co-pay levels or determine

covered benefits and services;

     (3) Release the results of a genetic test without the prior written authorization of the

individual from whom the test was obtained, except in a format where individual identifiers are

removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient

of information pursuant to this section may use or disclose the information solely to carry out the

purpose for which the information was disclosed. Authorization shall be required for each re-

disclosure. An exception shall exist for participation in research settings governed by the federal

policy for the protection of human research subjects (also known as "The Common Rule"); or

     (4) Request or require information as to whether an individual has ever had a genetic test,

or participated in genetic testing of any kind, whether for clinical or research purposes.

     (c) For the purposes of this section, "genetic testing" is the analysis of an individual's DNA,

RNA, chromosomes, protein and certain metabolites in order to detect heritable inheritable disease-

related genotypes, mutations, phenotypes or karyotypes for clinical purposes. Those purposes

include predicting risk of disease, identifying carriers, establishing prenatal and clinical diagnosis

or prognosis. Prenatal, newborn and carrier screening, and testing in high risk families may be

included provided there is an approved release by a parent or guardian. Tests for metabolites are

covered only when they are undertaken with high probability that an excess or deficiency of the

metabolite indicates the presence of heritable mutations in single genes. "Genetic testing" does not

mean routine physical measurement, a routine chemical, blood, or urine analysis or a test for drugs

or for HIV infections.

     (d) For the purposes of this section, "genetic testing" includes at-home genetic test kits.

LC005279 - Page 5 of 7

     SECTION 5. This act shall take effect upon passage.

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LC005279

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

***

     This act would refine the current law so that the prohibition against denial of insurance

coverage and for increased rates for person undergoing genetic testing will include at home genetic

testing.

     This act would take effect upon passage.

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