2023 -- S 0579

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LC002184

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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 -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

     Introduced By: Senators Lauria, Miller, DiPalma, Euer, DiMario, Lawson, Valverde,
Murray, and Kallman

     Date Introduced: March 07, 2023

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18.8 of the General Laws entitled "Health Care Accessibility and

Quality Assurance Act" is hereby amended by adding thereto the following section:

     27-18.8-11. Contracts with providers for mental health and substance use disorder

services.

     (a) Before January 1, 2024, and whenever necessitated by changes thereafter, but no less

frequently than annually, each healthcare entity or network plan shall compile and report to the

office of the health insurance commissioner a summary of how the healthcare entity or network

plan requires its contracted providers to submit claims for in-network outpatient behavioral health

services, including through the use of particular current procedural terminology (CPT) codes

specific to behavioral health services, through the use of modifiers particular to behavioral health

services appended to CPT codes of general usage, or through other formal requirements which

identify a particular claim as pertaining to in-network outpatient behavioral health services.

     (b) A healthcare entity or network plan shall include in every contract with a provider for

in-network outpatient behavioral health (including substance use disorder) services, or for

outpatient diagnostic or therapeutic services with a behavioral health (including substance use

disorder) modifier, a provision that, as of January 1, 2024, rates paid under such contract for those

services shall be subject to a one-time average increase of no less than the United States Department

of Labor All Urban Consumer All Items Less Food and Energy CPI (“CPI-Urban”) percentage

increase (determined by the health insurance commissioner by October 1, 2023, based on the most

recently published United States Department of Labor data as of that date) plus five percent (5%).

     SECTION 2. 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 -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

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     This act would require each healthcare entity or network plan to compile and report to the

health insurance commissioner a summary of how the healthcare entity or network plan requires

its contracted providers to submit claims for in-network outpatient behavioral health services,

before January 1, 2024, and at least annually thereafter and require rates paid under those contracts

for services be increased by the rate of inflation as of October 1, 2023, plus five percent (5%).

     This act would take effect upon passage.

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