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 proposed legislation is anticipated to impact state laws related to healthcare insurance and access to mental health treatment. By requiring that contracts with providers include specific claims submission processes and guaranteed rate increases, the bill aims to protect both providers and patients. This could lead to an increase in mental health service utilization, as clearer billing procedures and better compensation may encourage providers to offer such services. Furthermore, it may also support enhanced oversight by the health insurance commissioner regarding the treatment of behavioral health services within the state.
Summary
Bill S0463, introduced in the Rhode Island General Assembly, seeks to enhance the transparency and accessibility of mental health and substance use disorder services within the state's healthcare system. The bill mandates that healthcare entities and network plans report annually on how they require providers to submit claims for in-network outpatient behavioral health services. This provision is aimed at ensuring that necessary behavioral health services are adequately recorded and billed, contributing to improved tracking and potentially better outcomes for patients seeking care.
Contention
While the bill aims to address significant issues within mental health care access, it may encounter opposition from some healthcare stakeholders concerned about the potential increased burden of compliance and reporting. Critics might argue that the additional administrative tasks could detract from the time and resources that could be focused on patient care. Nevertheless, proponents assert that the long-term benefits of improved access and quality of mental health services justifies the need for these measures, emphasizing that addressing behavioral health is critical for overall public health.
Further_notes
The bill is set to take effect upon passage, indicating a sense of urgency to reform mental health services accessibility. It is crucial for stakeholders, including insurance providers, healthcare professionals, and advocacy groups, to engage in discussions surrounding the implementation and possible unintended consequences of such legislation.
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.
Requires that healthcare entities and network plans, eff. 1/1/25, include provision in every contract with a provider of mental health/substance use disorders that rates paid pursuant to the contract would be subject to a rate increase at least annually.
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
Prohibits contractors and subcontractors from paying employees the cash equivalent of any applicable healthcare benefit in lieu of actually purchasing the healthcare benefit unless the employee is covered under a different healthcare plan.
Requires that the department of human services and the department of behavioral healthcare, developmental disabilities and hospitals provide forecasted costs reflecting the recommended rate review on a monthly basis.
Requires that the department of human services and the department of behavioral healthcare, developmental disabilities and hospitals provide forecasted costs reflecting the recommended rate review on a monthly basis.