2023 -- H 5175

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LC000049

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --

ACCESSIBLE RESIDENCE MODIFICATIONS

     

     Introduced By: Representatives McNamara, and Noret

     Date Introduced: January 19, 2023

     Referred To: House Health & Human Services

     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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      27-18-91. Coverage for accessible residence modifications.

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     (a) Every individual or group hospital or medical expense insurance policy or individual

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group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

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state on or after July 1, 2024 shall provide coverage for accessible residence modifications when

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determined to be medically necessary and ordered by a physician after making a thorough

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evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

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modification the patient would have to move into a long-term care residential facility.

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     (b) This section 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; and

 

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     (9) Other limited benefit policies.

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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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     27-19-83. Coverage for accessible residence modifications.

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     (a) Every individual or group hospital or medical expense insurance policy or individual

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group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

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state on or after July 1, 2024 shall provide coverage for accessible residence modifications when

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determined to be medically necessary and ordered by a physician after making a thorough

9

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

10

modification the patient would have to move into a long-term care residential facility.

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     (b) This section 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; and

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     (9) Other limited benefit policies.

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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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     27-20-79. Coverage for accessible residence modifications.

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     (a) Every individual or group hospital or medical expense insurance policy or individual

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group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

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state on or after July 1, 2024 shall provide coverage for accessible residence modifications when

27

determined to be medically necessary and ordered by a physician after making a thorough

28

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

29

modification the patient would have to move into a long-term care residential facility.

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     (b) This section 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;

 

LC000049 - Page 2 of 4

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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; and

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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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     27-41-96. Coverage for accessible residence modifications.

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     (a) Every individual or group hospital or medical expense insurance policy or individual

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group hospital or medical services plan contract delivered, issued for delivery, or renewed in this

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state on or after July 1, 2024 shall provide coverage for accessible residence modifications when

12

determined to be medically necessary and ordered by a physician after making a thorough

13

evaluation of the patient’s physical or physiological limitations, that absent the accessible residence

14

modification the patient would have to move into a long-term care residential facility.

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     (b) This section 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; and

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     (9) Other limited benefit policies.

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     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 --

ACCESSIBLE RESIDENCE MODIFICATIONS

***

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     This act would require health insurance plans to provide coverage for accessible residence

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modifications when those modifications are determined to be medically necessary, but only after a

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physician makes a determination that absent the accessible modifications, the patient would have

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to move into a long-term care residential facility.

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     This act would take effect upon passage.

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