2023 -- H 6076 | |
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LC002233 | |
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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 | |
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Introduced By: Representatives Shanley, and Donovan | |
Date Introduced: March 03, 2023 | |
Referred To: House 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 Insurance |
2 | Policies" is hereby amended by adding thereto the following section: |
3 | 27-18-91. Coverage for naturopathy. |
4 | Every individual or group health insurance contract, plan, or policy contract delivered, |
5 | issued for delivery, or renewed in this state on or after January 1, 2024, shall provide coverage for |
6 | naturopathy performed by an individual licensed under chapter 36.1 of title 5. |
7 | SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service |
8 | Corporations" is hereby amended by adding the following section thereto: |
9 | 27-19-83. Coverage for naturopathy. |
10 | Every individual or group health insurance contract, plan, or policy contract delivered, |
11 | issued for delivery, or renewed in this state on or after January 1, 2024, shall provide coverage for |
12 | naturopathy performed by an individual licensed under chapter 36.1 of title 5. |
13 | SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service |
14 | Corporations" is hereby amended by adding thereto the following section: |
15 | 27-20-79. Coverage for naturopathy. |
16 | Every individual or group health insurance contract, plan, or policy contract delivered, |
17 | issued for delivery, or renewed in this state on or after January 1, 2024, shall provide coverage for |
18 | naturopathy performed by an individual licensed under chapter 36.1 of title 5. |
19 | SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance |
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1 | Organizations" is hereby amended by adding thereto the following section: |
2 | 27-41-96. Coverage for naturopathy. |
3 | Every individual or group health insurance contract, plan, or policy contract delivered, |
4 | issued for delivery, or renewed in this state on or after January 1, 2024, shall provide coverage for |
5 | naturopathy performed by an individual licensed under chapter 36.1 of title 5. |
6 | SECTION 2. Section 27-38.2-1 of the General Laws in Chapter 27-38.2 entitled "Insurance |
7 | Coverage for Mental Illness and Substance Abuse" is hereby amended to read as follows: |
8 | 27-38.2-1. Coverage for treatment of mental health and substance use disorders. |
9 | (a) A group health plan and an individual or group health insurance plan shall provide |
10 | coverage for the treatment of mental health and substance use disorders under the same terms and |
11 | conditions as that coverage is provided for other illnesses and diseases. |
12 | (b) Coverage for the treatment of mental health and substance use disorders shall not |
13 | impose any annual or lifetime dollar limitation. |
14 | (c) Financial requirements and quantitative treatment limitations on coverage for the |
15 | treatment of mental health and substance use disorders shall be no more restrictive than the |
16 | predominant financial requirements applied to substantially all coverage for medical conditions in |
17 | each treatment classification. |
18 | (d) Coverage shall not impose non-quantitative treatment limitations for the treatment of |
19 | mental health and substance use disorders unless the processes, strategies, evidentiary standards, |
20 | or other factors used in applying the non-quantitative treatment limitation, as written and in |
21 | operation, are comparable to, and are applied no more stringently than, the processes, strategies, |
22 | evidentiary standards, or other factors used in applying the limitation with respect to |
23 | medical/surgical benefits in the classification. |
24 | (e) The following classifications shall be used to apply the coverage requirements of this |
25 | chapter: (1) Inpatient, in-network; (2) Inpatient, out-of-network; (3) Outpatient, in-network; (4) |
26 | Outpatient, out-of-network; (5) Emergency care; and (6) Prescription drugs. |
27 | (f) Medication-assisted treatment or medication-assisted maintenance services of substance |
28 | use disorders, opioid overdoses, and chronic addiction, including methadone, buprenorphine, |
29 | naltrexone, or other clinically appropriate medications, is included within the appropriate |
30 | classification based on the site of the service. |
31 | (g) Payors shall rely upon the criteria of the American Society of Addiction Medicine when |
32 | developing coverage for levels of care for substance use disorder treatment. |
33 | (h) Patients with substance use disorders shall have access to evidence-based, non-opioid |
34 | treatment for pain, therefore coverage shall apply to medically necessary chiropractic care and |
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1 | osteopathic manipulative treatment performed by an individual licensed under § 5-37-2, as well as |
2 | coverage for naturopathy under chapter 36.1 of title 5 effective January 1, 2024. |
3 | (i) Parity of cost-sharing requirements. Regardless of the professional license of the |
4 | provider of care, if that care is consistent with the provider’s scope of practice and the health plan’s |
5 | credentialing and contracting provisions, cost-sharing for behavioral health counseling visits and |
6 | medication maintenance visits shall be consistent with the cost-sharing applied to primary care |
7 | office visits. |
8 | SECTION 6. This act shall take effect upon passage. |
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LC002233 | |
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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 health insurance contract plans or policies to provide coverage for |
2 | the licensed practice of naturopathy as provided in chapter 36.1 of title 5 effective January 1, 2024. |
3 | This act would take effect upon passage. |
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