2023 -- H 5744
========
LC000252
========
S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By: Representatives Morales, Alzate, McGaw, Carson, Cruz, Kislak, Tanzi,
Giraldo, Donovan, and Kennedy
Date Introduced: February 21, 2023
Referred To: House Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1
Policies" is hereby amended by adding thereto the following section: 2
27-18-91. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for 3
the prevention of HIV and post-exposure prophylaxis to prevent HIV infection. 4
(a) Every group health insurance contract, or every group hospital or medical expense 5
insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by 6
any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of 7
pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) 8
to prevent HIV infection. 9
(b) The healthcare benefits outlined in this section apply only to services delivered within 10
the state of Rhode Island; provided, that all health insurance carriers shall be required to provide 11
coverage for those benefits mandated by this section outside of the state of Rhode Island where it 12
can be established through a pre-authorization process that the required services are not available 13
in the state of Rhode Island from a provider in the health insurance carrier’s network. 14
(c) Each health insurance carrier shall collect and provide to the office of the health 15
insurance commissioner, in a form and frequency acceptable to the commissioner, information and 16
data reflecting the costs and the savings of adding the benefit coverage provided in this section. 17
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 18
Corporations" is hereby amended by adding thereto the following section: 19
LC000252 - Page 2 of 4
27-19-83. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for 1
the prevention of HIV and post-exposure prophylaxis to prevent HIV infection. 2
(a) Every group health insurance contract, or every group hospital or medical expense 3
insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by 4
any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of 5
pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) 6
to prevent HIV infection. 7
(b) The healthcare benefits outlined in this section apply only to services delivered within 8
the state of Rhode Island; provided, that all health insurance carriers shall be required to provide 9
coverage for those benefits mandated by this section outside of the state of Rhode Island where it 10
can be established through a pre-authorization process that the required services are not available 11
in the state of Rhode Island from a provider in the health insurance carrier’s network. 12
(c) Each health insurance carrier shall collect and provide to the office of the health 13
insurance commissioner, in a form and frequency acceptable to the commissioner, information and 14
data reflecting the costs and the savings of adding the benefit coverage provided in this section. 15
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 16
Corporations" is hereby amended by adding thereto the following section: 17
27-20-79. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for 18
the prevention of HIV and post-exposure prophylaxis to prevent HIV infection. 19
(a) Every group health insurance contract, or every group hospital or medical expense 20
insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by 21
any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of 22
pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) 23
to prevent HIV infection. 24
(b) The healthcare benefits outlined in this section apply only to services delivered within 25
the state of Rhode Island; provided, that all health insurance carriers shall be required to provide 26
coverage for those benefits mandated by this section outside of the state of Rhode Island where it 27
can be established through a pre-authorization process that the required services are not available 28
in the state of Rhode Island from a provider in the health insurance carrier’s network. 29
(c) Each health insurance carrier shall collect and provide to the office of the health 30
insurance commissioner, in a form and frequency acceptable to the commissioner, information and 31
data reflecting the costs and the savings of adding the benefit coverage provided in this section. 32
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 33
Organizations" is hereby amended by adding thereto the following section: 34
LC000252 - Page 3 of 4
27-41-96. Mandatory coverage for treatment of pre-exposure prophylaxis (PrEP) for 1
the prevention of HIV and post-exposure prophylaxis to prevent HIV infection. 2
(a) Every group health insurance contract, or every group hospital or medical expense 3
insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by 4
any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of 5
pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) 6
to prevent HIV infection. 7
(b) The healthcare benefits outlined in this section apply only to services delivered within 8
the state of Rhode Island; provided, that all health insurance carriers shall be required to provide 9
coverage for those benefits mandated by this section outside of the state of Rhode Island where it 10
can be established through a pre-authorization process that the required services are not available 11
in the state of Rhode Island from a provider in the health insurance carrier’s network. 12
(c) Each health insurance carrier shall collect and provide to the office of the health 13
insurance commissioner, in a form and frequency acceptable to the commissioner, information and 14
data reflecting the costs and the savings of adding the benefit coverage provided in this section. 15
SECTION 5. This act shall take effect upon passage. 16
========
LC000252
========
LC000252 - Page 4 of 4
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
***
This act would require coverage for the treatment of pre-exposure prophylaxis (PrEP) for 1
the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection, commencing 2
January 1, 2024. 3
This act would take effect upon passage. 4
========
LC000252
========