Rhode Island House Bill H5561

Rhode Island 2025 Regular Session

• Introduced: 2/26/25
• Refer: 2/26/25
• Report Pass: 5/8/25
• Engrossed: 6/3/25
• Refer: 6/11/25

Caption

Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.

Impact

If enacted, H5561 will significantly alter the landscape of healthcare payments in the state. It will mandate that healthcare entities and health plans comply with specific processing time frames when they receive claims and provide clear notification regarding any claim denials. Additionally, the bill imposes a requirement for interest payments on late reimbursements, which could incentivize faster processing and compliance with established timelines. This could lead to improvements in cash flow for healthcare providers and instill more confidence in policyholders regarding their coverage.

Summary

House Bill H5561 aims to prohibit healthcare providers and health plans from denying the payment of a medical bill solely because the bill arises from a third-party claim, excluding workers' compensation claims. By establishing this rule, the bill seeks to protect policyholders and healthcare providers from potential disenfranchisement when third-party claims are involved, ensuring that the right to payment is preserved under broader circumstances. This amendment is designed to streamline the claims process and reduce complexities that could hinder prompt payments for medical services rendered.

Contention

There are notable concerns surrounding this bill, particularly from industries and entities that may face financial implications as a result of stricter reimbursement obligations. Critics may argue that requiring healthcare entities to pay for claims associated with third-party incidents could lead to increased insurance costs or burdens on the healthcare system. Additionally, exceptions outlined within the bill, such as claims submitted beyond ninety days, could generate disputes and confusion, complicating the claims resolution process rather than simplifying it. Overall, while the intentions behind H5561 may be to protect stakeholders in the healthcare industry, the enforcement and practical application of these regulations will require careful consideration.