2023 -- H 5744

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LC000252

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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

     

     Introduced By: Representatives Morales, Alzate, McGaw, Carson, Cruz, Kislak, Tanzi,
Giraldo, Donovan, and Kennedy

     Date Introduced: February 21, 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 Insurance

2

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

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     27-18-91. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for

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the prevention of HIV and post-exposure prophylaxis to prevent HIV infection.

5

     (a) Every group health insurance contract, or every group hospital or medical expense

6

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

7

any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of

8

pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP)

9

to prevent HIV infection.

10

     (b) The healthcare benefits outlined in this section apply only to services delivered within

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the state of Rhode Island; provided, that all health insurance carriers shall be required to provide

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coverage for those benefits mandated by this section outside of the state of Rhode Island where it

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can be established through a pre-authorization process that the required services are not available

14

in the state of Rhode Island from a provider in the health insurance carrier’s network.

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     (c) Each health insurance carrier shall collect and provide to the office of the health

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insurance commissioner, in a form and frequency acceptable to the commissioner, information and

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data reflecting the costs and the savings of adding the benefit coverage provided in this section.

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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:

 

1

     27-19-83. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for

2

the prevention of HIV and post-exposure prophylaxis to prevent HIV infection.

3

     (a) Every group health insurance contract, or every group hospital or medical expense

4

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

5

any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of

6

pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP)

7

to prevent HIV infection.

8

     (b) The healthcare benefits outlined in this section apply only to services delivered within

9

the state of Rhode Island; provided, that all health insurance carriers shall be required to provide

10

coverage for those benefits mandated by this section outside of the state of Rhode Island where it

11

can be established through a pre-authorization process that the required services are not available

12

in the state of Rhode Island from a provider in the health insurance carrier’s network.

13

     (c) Each health insurance carrier shall collect and provide to the office of the health

14

insurance commissioner, in a form and frequency acceptable to the commissioner, information and

15

data reflecting the costs and the savings of adding the benefit coverage provided in this section.

16

     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. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for

19

the prevention of HIV and post-exposure prophylaxis to prevent HIV infection.

20

     (a) Every group health insurance contract, or every group hospital or medical expense

21

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

22

any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of

23

pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP)

24

to prevent HIV infection.

25

     (b) The healthcare benefits outlined in this section apply only to services delivered within

26

the state of Rhode Island; provided, that all health insurance carriers shall be required to provide

27

coverage for those benefits mandated by this section outside of the state of Rhode Island where it

28

can be established through a pre-authorization process that the required services are not available

29

in the state of Rhode Island from a provider in the health insurance carrier’s network.

30

     (c) Each health insurance carrier shall collect and provide to the office of the health

31

insurance commissioner, in a form and frequency acceptable to the commissioner, information and

32

data reflecting the costs and the savings of adding the benefit coverage provided in this section.

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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:

 

LC000252 - Page 2 of 4

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     27-41-96. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for

2

the prevention of HIV and post-exposure prophylaxis to prevent HIV infection.

3

     (a) Every group health insurance contract, or every group hospital or medical expense

4

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

5

any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of

6

pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP)

7

to prevent HIV infection.

8

     (b) The healthcare benefits outlined in this section apply only to services delivered within

9

the state of Rhode Island; provided, that all health insurance carriers shall be required to provide

10

coverage for those benefits mandated by this section outside of the state of Rhode Island where it

11

can be established through a pre-authorization process that the required services are not available

12

in the state of Rhode Island from a provider in the health insurance carrier’s network.

13

     (c) Each health insurance carrier shall collect and provide to the office of the health

14

insurance commissioner, in a form and frequency acceptable to the commissioner, information and

15

data reflecting the costs and the savings of adding the benefit coverage provided in this section.

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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

***

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     This act would require coverage for the treatment of pre-exposure prophylaxis (PrEP) for

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the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection, commencing

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January 1, 2024.

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     This act would take effect upon passage.

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