Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.
Impact
The legislation emphasizes the improvement of financial conditions for outpatient behavioral health services by requiring a one-time average increase in payment rates based on the rate of inflation, determined by the health insurance commissioner. This increase is calculated from existing standards set by the United States Department of Labor and is intended to provide a buffer against the rising costs faced by mental health and substance use disorder treatment providers. It reflects a broader recognition of the importance of behavioral health in overall healthcare quality and accessibility.
Summary
Senate Bill S2180, also referred to as the Health Care Accessibility and Quality Assurance Act, was introduced to enhance the reporting requirements for healthcare entities and network plans regarding outpatient behavioral health services. The bill mandates that by January 1, 2025, each healthcare provider must compile and report to the health insurance commissioner a detailed summary of how they require contracted providers to submit claims related to these services. This aims to streamline the claims process and ensure transparency in how behavioral health services are billed.
Contention
While the bill proposes beneficial changes to the handling of outpatient behavioral health services, it may face challenges related to implementation and compliance from healthcare providers. Concerns may arise regarding the administrative burden of compiling reports and adapting contracts to include new payment structures. Moreover, discussions may highlight the balance between improving healthcare accessibility and managing the financial implications for insurance networks. Stakeholders, including legislators and health advocates, will likely debate the effectiveness of these measures in addressing the existing gaps in mental health services.
House Resolution Respectfully Requesting The Office Of The Health Insurance Commissioner To Study, Publicly Report Data On, And Provide Recommendations For, Addressing The Critical Inadequacy Of Access To Behavioral Health Services In Rhode Island's Commercial Insurance Networks
Determination Of Need For New Healthcare Equipment And New Institutional Health Services -- Licensing Of Healthcare Facilities -- The Hospital Conversions Act