Rhode Island 2025 Regular Session

Rhode Island House Bill H5624

Introduced
2/26/25  

Caption

Removes the age restriction for benefits coverage/requires, after 1/1/26, for policies issued or renewed include coverage for reimbursement for provider services at a rate equal to, or greater than, Medicaid establishments of EOHHS.

Impact

If enacted, H5624 would significantly alter the landscape of insurance coverage for autism treatment in Rhode Island. By removing the age cap on benefits, the bill ensures that those in need of ongoing support and treatment can receive necessary services regardless of age. Additionally, by stipulating minimum reimbursement rates for ABA services, the bill aims to improve access to care and ensure that providers are adequately compensated. This is likely to enhance the quality and availability of autism-related healthcare services across the state, benefitting families and individuals affected by autism.

Summary

House Bill 5624, introduced in Rhode Island, seeks to amend existing laws regarding health insurance coverage for autism spectrum disorders. The bill's primary objective is to eliminate age restrictions on benefits provision, allowing coverage to continue for individuals with autism spectrum disorders beyond the current limit of age fifteen. Furthermore, it mandates that health insurance plans issued or renewed after January 1, 2026, must include reimbursement for applied behavior analysis (ABA) services, a critical treatment approach for autism, at rates equal to or greater than the prevailing integrated state Medicaid rate as established by the executive office of health and human services.

Contention

While the bill has garnered support from many advocacy groups and families seeking improved services for autism treatment, it may face scrutiny regarding its implications on insurance providers. Concerns could arise regarding the financial burdens on health insurance companies, particularly regarding mandated coverage without equivalent adjustments in premium rates. As a result, stakeholders may debate the sustainability of this mandate in the long term, weighing its beneficial effects on access to autism care against potential increases in healthcare costs.

Companion Bills

No companion bills found.

Previously Filed As

RI S2612

Requires that any insurance contract issued, amended or renewed on or after January 1, 2025, that provides hospital, medical or surgical coverage shall provide coverage for medically necessary treatment of mental health or substance use disorders.

RI S2723

Includes the definition of "primary care services" and requires that all biennial reports shall include a review and recommendation of rates for primary care services on and after September 1, 2025.

RI H7273

Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.

RI S2401

Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.

RI H6218

Insurance Coverage For Mental Illness And Substance Abuse

RI S2076

Removes the sunset provision of all statutory law requiring coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

RI H8171

Removes the sunset provision of all statutory law requiring coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

RI H7299

Requires health insurance policies to provide coverage for the licensed practice of naturopathy and to provide reports.

RI S2384

Requires health insurance policies to provide coverage for the licensed practice of naturopathy and to provide reports.

RI H7877

Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of testing and treating infertility, including preimplantation genetic testing (PGT), in conjunction with in vitro fertilization (IVF).

Similar Bills

No similar bills found.