Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.
Impact
The enactment of S2606 is expected to significantly impact state laws governing health insurance by broadening the scope of coverage to include community health worker services, which were previously not uniformly covered. The amendment to insurance contracts represents a shift towards recognizing the valuable roles that community health workers play in managing chronic health issues and promoting public health. Additionally, insurance companies will be required to report data regarding utilization and costs of these services, facilitating better oversight and understanding of their impact on healthcare delivery.
Summary
Bill S2606 seeks to mandate that health insurance policies in Rhode Island provide coverage for the services of community health workers beginning January 1, 2025. The bill defines community health workers as trained professionals who deliver essential services to individuals with chronic health conditions, those at risk for such conditions, and others facing barriers to addressing their health or social needs. Covered services include health education, resource coordination, care planning, and follow-up care recommendations. This initiative aims to enhance healthcare access for underserved communities and support holistic health management.
Sentiment
The general sentiment surrounding S2606 appears to be supportive, particularly among stakeholders in public health and healthcare advocacy. Proponents argue that the bill will enhance accessibility to health services for vulnerable populations and address significant gaps in the current healthcare framework. However, there may be concerns from some insurance providers regarding potential increases in costs and a possible strain on existing resources, indicating a need for careful implementation and management of these changes.
Contention
Despite the positive outlook, some points of contention may arise regarding the logistics of implementing this bill, particularly in terms of reimbursement structures and the training requirements for community health workers. Insurers might question how these changes will affect their operations and profitability. Additionally, there may be technical details in the legislation concerning oversight and reporting requirements that could lead to debates among lawmakers and industry representatives as the bill is rolled out.
Determination Of Need For New Healthcare Equipment And New Institutional Health Services -- Licensing Of Healthcare Facilities -- The Hospital Conversions Act
Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.
Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.
Requires health insurance plans to cover services provided by licensed certified professional midwives. Insurers must report utilization and cost data annually. Certain limited benefit policies are exempt.
Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.
To Regulate The Reimbursement Rate Of A Birth Under An Insurance Policy In This State; And To Establish The Reimbursement Rate For A Birth To Be At Least The Same As The Reimbursement Rate For A Birth By Cesarean Section.
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.