Chapter 202

2012 -- S 2129

Enacted 06/11/12

 

A N A C T

RELATING TO INSURANCE

          

     Introduced By: Senators Nesselbush, P Fogarty, Sosnowski, Cote, and Crowley

     Date Introduced: January 18, 2012

     

It is enacted by the General Assembly as follows:

 

     SECTION 1. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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

 

     27-20-65. Primary care provider designation requirement. – Every individual or

group health insurance contract, or every individual or group hospital or medical expense

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

or after January 1, 2013, shall require that the subscriber and each dependent designate a

participating primary care provider and the insurer shall collect the designation from the insured.

Designation of a primary care provider shall not be a condition of enrollment and failure to

designate a primary care provider shall not constitute grounds for cancellation of coverage. For

purposes of this section, “primary care provider” means the physician, practice or other medical

provider considered by the insured to be his or her usual source of medical care.

 

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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

 

     27-19-69. Primary care provider designation requirement. Every individual or

group health insurance contract, or every individual or group hospital or medical expense

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

or after January 1, 2013, shall require that the subscriber and each dependent designate a

participating primary care provider and the insurer shall collect the designation from the insured.

Designation of a primary care provider shall not be a condition of enrollment and failure to

designate a primary care provider shall not constitute grounds for cancellation of coverage. For

purposes of this section, “primary care provider” means the physician, practice or other medical

provider considered by the insured to be his or her usual source of medical care.

 

     SECTION 3. Chapter 27-18 of the General Laws entitled "Accident and Sickness

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

 

     27-18-78. Primary care provider designation requirement. (a) Every individual or

group health insurance contract, or every individual or group hospital or medical expense

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

or after January 1, 2013, shall require that the subscriber and each dependent designate a

participating primary care provider and the insurer shall collect the designation from the insured.

Designation of a primary care provider shall not be a condition of enrollment and failure to

designate a primary care provider shall not constitute grounds for cancellation of coverage. For

purposes of this section, “primary care provider” means the physician, practice or other medical

provider considered by the insured to be his or her usual source of medical care.

     (b) Requirements for designating a primary care provider enumerated in subsection (a)

shall not apply to insurance coverage providing benefits for:

     (1) Hospital confinement indemnity;

     (2) Disability income;

     (3) Accident only;

     (4) Long-term care;

     (5) Medicare supplement;

     (6) Limited benefit health;

     (7) Specified disease indemnity;

     (8) Sickness or bodily injury or death by accident or both; or

     (9) Other limited benefit policies.

 

     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

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

 

     27-41-82. Primary care provider designation requirement. -- Every individual or

group health insurance contract, or every individual or group hospital or medical expense

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

or after January 1, 2013, shall require that the subscriber and each dependent designate a

participating primary care provider and the insurer shall collect the designation from the insured.

Designation of a primary care provider shall not be a condition of enrollment and failure to

designate a primary care provider shall not constitute grounds for cancellation of coverage. For

purposes of this section, “primary care provider” means the physician, practice or other medical

provider considered by the insured to be his or her usual source of medical care.

 

     SECTION 5. The health insurance commissioner is authorized to promulgate regulations

to implement this act.

 

     SECTION 6. This act shall take effect on January 1, 2013.

     

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LC00414

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