Rhode Island 2025 Regular Session

Rhode Island House Bill H5861 Compare Versions

Only one version of the bill is available at this time.

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5	5	2025 -- H 5861
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7	7	LC001900
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
16	16	Introduced By: Representatives Stewart, Fogarty, McGaw, Cruz, and Casimiro
17	17	Date Introduced: February 28, 2025
18	18	Referred To: House Health & Human Services
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20	20
21	21	It is enacted by the General Assembly as follows:
22	22	SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1
23	23	Policies" is hereby amended by adding thereto the following section: 2
24	24	27-18-95. Licensed certified lactation counselor. 3
25	25	(a) As used in this section, “licensed certified lactation counselor” means a trained 4
26	26	professional who holds a licensure and certification by the department of health in accordance with 5
27	27	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 6
28	28	evaluation, problem identification, treatment, education, and consultation to provide lactation care 7
29	29	and services to childbearing families, and infant children from birth to twelve (12) months old 8
30	30	within the scope of practice pursuant to the provisions of § 23-13.8-9. 9
31	31	(b) Every individual or group health insurance contract, or every individual or group 10
32	32	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 11
33	33	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 12
34	34	lactation counselors in accordance with each health insurers' respective principles and mechanisms 13
35	35	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 14
36	36	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 15
37	37	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 16
38	38	care provider. No insurer or hospital or medical service corporation may require supervision, 17
39	39	signature, or referral by any other health care provider as a condition of reimbursement, except 18
40	40	when those requirements are also applicable to other categories of health care providers. No insurer 19
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43	43	LC001900 - Page 2 of 6
44	44	or hospital or medical service corporation or patient may be required to pay for duplicate services 1
45	45	actually rendered by both a licensed certified lactation counselor and any other health care provider. 2
46	46	(c) Every individual or group health insurance contract, or every individual or group 3
47	47	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
48	48	or renewed in this state that is required to cover licensed certified lactation counselor services 5
49	49	defined in subsection (a) of this section, shall report utilization and cost information related to 6
50	50	licensed certified lactation counselor services to the office of the health insurance commissioner on 7
51	51	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 8
52	52	shall define the utilization and cost information required to be reported. 9
53	53	(d) This section shall not apply to insurance coverage providing benefits for: 10
54	54	(1) Hospital confinement indemnity; 11
55	55	(2) Disability income; 12
56	56	(3) Accident only; 13
57	57	(4) Long-term care; 14
58	58	(5) Medicare supplement; 15
59	59	(6) Limited benefit health; 16
60	60	(7) Specified disease indemnity; 17
61	61	(8) Sickness or bodily injury or death by accident or both; and 18
62	62	(9) Other limited benefit policies. 19
63	63	SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 20
64	64	Corporations" is hereby amended by adding thereto the following section: 21
65	65	27-19-87. Licensed certified lactation counselor. 22
66	66	(a) As used in this section, “licensed certified lactation counselor” means a trained 23
67	67	professional who holds a licensure and certification by the department of health in accordance with 24
68	68	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 25
69	69	evaluation, problem identification, treatment, education, and consultation to provide lactation care 26
70	70	and services to childbearing families, and infant children from birth to twelve (12) months old 27
71	71	within the scope of practice pursuant to the provisions of § 23-13.8-9. 28
72	72	(b) Every individual or group health insurance contract, or every individual or group 29
73	73	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 30
74	74	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 31
75	75	lactation counselors in accordance with each health insurers' respective principles and mechanisms 32
76	76	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 33
77	77	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 34
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79	79
80	80	LC001900 - Page 3 of 6
81	81	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 1
82	82	care provider. No insurer or hospital or medical service corporation may require supervision, 2
83	83	signature, or referral by any other health care provider as a condition of reimbursement, except 3
84	84	when those requirements are also applicable to other categories of health care providers. No insurer 4
85	85	or hospital or medical service corporation or patient may be required to pay for duplicate services 5
86	86	actually rendered by both a licensed certified lactation counselor and any other health care provider. 6
87	87	(c) Every individual or group health insurance contract, or every individual or group 7
88	88	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 8
89	89	or renewed in this state that is required to cover licensed certified lactation counselor services 9
90	90	defined in subsection (a) of this section, shall report utilization and cost information related to 10
91	91	licensed certified lactation counselor services to the office of the health insurance commissioner on 11
92	92	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 12
93	93	shall define the utilization and cost information required to be reported. 13
94	94	(d) This section shall not apply to insurance coverage providing benefits for: 14
95	95	(1) Hospital confinement indemnity; 15
96	96	(2) Disability income; 16
97	97	(3) Accident only; 17
98	98	(4) Long-term care; 18
99	99	(5) Medicare supplement; 19
100	100	(6) Limited benefit health; 20
101	101	(7) Specified disease indemnity; 21
102	102	(8) Sickness or bodily injury or death by accident or both; and 22
103	103	(9) Other limited benefit policies. 23
104	104	SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 24
105	105	Corporations" is hereby amended by adding thereto the following section: 25
106	106	27-20-83. Licensed certified lactation counselor. 26
107	107	(a) As used in this section, “licensed certified lactation counselor” means a trained 27
108	108	professional who holds a licensure and certification by the department of health in accordance with 28
109	109	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 29
110	110	evaluation, problem identification, treatment, education, and consultation to provide lactation care 30
111	111	and services to childbearing families, and infant children from birth to twelve (12) months old 31
112	112	within the scope of practice pursuant to the provisions of § 23-13.8-9. 32
113	113	(b) Every individual or group health insurance contract, or every individual or group 33
114	114	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 34
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117	117	LC001900 - Page 4 of 6
118	118	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 1
119	119	lactation counselors in accordance with each health insurers' respective principles and mechanisms 2
120	120	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 3
121	121	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 4
122	122	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 5
123	123	care provider. No insurer or hospital or medical service corporation may require supervision, 6
124	124	signature, or referral by any other health care provider as a condition of reimbursement, except 7
125	125	when those requirements are also applicable to other categories of health care providers. No insurer 8
126	126	or hospital or medical service corporation or patient may be required to pay for duplicate services 9
127	127	actually rendered by both a licensed certified lactation counselor and any other health care provider. 10
128	128	(c) Every individual or group health insurance contract, or every individual or group 11
129	129	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 12
130	130	or renewed in this state that is required to cover licensed certified lactation counselor services 13
131	131	defined in subsection (a) of this section, shall report utilization and cost information related to 14
132	132	licensed certified lactation counselor services to the office of the health insurance commissioner on 15
133	133	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 16
134	134	shall define the utilization and cost information required to be reported. 17
135	135	(d) This section shall not apply to insurance coverage providing benefits for: 18
136	136	(1) Hospital confinement indemnity; 19
137	137	(2) Disability income; 20
138	138	(3) Accident only; 21
139	139	(4) Long-term care; 22
140	140	(5) Medicare supplement; 23
141	141	(6) Limited benefit health; 24
142	142	(7) Specified disease indemnity; 25
143	143	(8) Sickness or bodily injury or death by accident or both; and 26
144	144	(9) Other limited benefit policies. 27
145	145	SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 28
146	146	Organizations" is hereby amended by adding thereto the following section: 29
147	147	27-41-100. Licensed certified lactation counselor. 30
148	148	(a) As used in this section, “licensed certified lactation counselor” means a trained 31
149	149	professional who holds a licensure and certification by the department of health in accordance with 32
150	150	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 33
151	151	evaluation, problem identification, treatment, education, and consultation to provide lactation care 34
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155	155	and services to childbearing families, and infant children from birth to twelve (12) months old 1
156	156	within the scope of practice pursuant to the provisions of § 23-13.8-9. 2
157	157	(b) Every individual or group health insurance contract, or every individual or group 3
158	158	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
159	159	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 5
160	160	lactation counselors in accordance with each health insurers' respective principles and mechanisms 6
161	161	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 7
162	162	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 8
163	163	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 9
164	164	care provider. No insurer or hospital or medical service corporation may require supervision, 10
165	165	signature, or referral by any other health care provider as a condition of reimbursement, except 11
166	166	when those requirements are also applicable to other categories of health care providers. No insurer 12
167	167	or hospital or medical service corporation or patient may be required to pay for duplicate services 13
168	168	actually rendered by both a licensed certified lactation counselor and any other health care provider. 14
169	169	(c) Every individual or group health insurance contract, or every individual or group 15
170	170	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 16
171	171	or renewed in this state that is required to cover licensed certified lactation counselor services 17
172	172	defined in subsection (a) of this section, shall report utilization and cost information related to 18
173	173	licensed certified lactation counselor services to the office of the health insurance commissioner on 19
174	174	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 20
175	175	shall define the utilization and cost information required to be reported. 21
176	176	(d) This section shall not apply to insurance coverage providing benefits for: 22
177	177	(1) Hospital confinement indemnity; 23
178	178	(2) Disability income; 24
179	179	(3) Accident only; 25
180	180	(4) Long-term care; 26
181	181	(5) Medicare supplement; 27
182	182	(6) Limited benefit health; 28
183	183	(7) Specified disease indemnity; 29
184	184	(8) Sickness or bodily injury or death by accident or both; and 30
185	185	(9) Other limited benefit policies. 31
186	186	SECTION 5. This act shall take effect on January 1, 2026. 32
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188	188	LC001900
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193	193	EXPLANATION
194	194	BY THE LEGISLATIVE COUNCIL
195	195	OF
196	196	A N A C T
197	197	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
198	198	***
199	199	This act would require health insurance policies to cover licensed certified lactation 1
200	200	counselor services for childbearing families. It would also prohibit requiring supervision or 2
201	201	duplicate payments for services and mandates annual reporting. 3
202	202	This act would take effect on January 1, 2026. 4
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204	204	LC001900
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