2025 -- H 5861
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LC001900
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By: Representatives Stewart, Fogarty, McGaw, Cruz, and Casimiro
Date Introduced: February 28, 2025
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
27-18-95. Licensed certified lactation counselor. 3
(a) As used in this section, “licensed certified lactation counselor” means a trained 4
professional who holds a licensure and certification by the department of health in accordance with 5
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 6
evaluation, problem identification, treatment, education, and consultation to provide lactation care 7
and services to childbearing families, and infant children from birth to twelve (12) months old 8
within the scope of practice pursuant to the provisions of § 23-13.8-9. 9
(b) Every individual or group health insurance contract, or every individual or group 10
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 11
or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 12
lactation counselors in accordance with each health insurers' respective principles and mechanisms 13
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 14
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 15
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 16
care provider. No insurer or hospital or medical service corporation may require supervision, 17
signature, or referral by any other health care provider as a condition of reimbursement, except 18
when those requirements are also applicable to other categories of health care providers. No insurer 19
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or hospital or medical service corporation or patient may be required to pay for duplicate services 1
actually rendered by both a licensed certified lactation counselor and any other health care provider. 2
(c) Every individual or group health insurance contract, or every individual or group 3
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
or renewed in this state that is required to cover licensed certified lactation counselor services 5
defined in subsection (a) of this section, shall report utilization and cost information related to 6
licensed certified lactation counselor services to the office of the health insurance commissioner on 7
or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 8
shall define the utilization and cost information required to be reported. 9
(d) This section shall not apply to insurance coverage providing benefits for: 10
(1) Hospital confinement indemnity; 11
(2) Disability income; 12
(3) Accident only; 13
(4) Long-term care; 14
(5) Medicare supplement; 15
(6) Limited benefit health; 16
(7) Specified disease indemnity; 17
(8) Sickness or bodily injury or death by accident or both; and 18
(9) Other limited benefit policies. 19
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 20
Corporations" is hereby amended by adding thereto the following section: 21
27-19-87. Licensed certified lactation counselor. 22
(a) As used in this section, “licensed certified lactation counselor” means a trained 23
professional who holds a licensure and certification by the department of health in accordance with 24
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 25
evaluation, problem identification, treatment, education, and consultation to provide lactation care 26
and services to childbearing families, and infant children from birth to twelve (12) months old 27
within the scope of practice pursuant to the provisions of § 23-13.8-9. 28
(b) Every individual or group health insurance contract, or every individual or group 29
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 30
or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 31
lactation counselors in accordance with each health insurers' respective principles and mechanisms 32
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 33
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 34
LC001900 - Page 3 of 6
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 1
care provider. No insurer or hospital or medical service corporation may require supervision, 2
signature, or referral by any other health care provider as a condition of reimbursement, except 3
when those requirements are also applicable to other categories of health care providers. No insurer 4
or hospital or medical service corporation or patient may be required to pay for duplicate services 5
actually rendered by both a licensed certified lactation counselor and any other health care provider. 6
(c) Every individual or group health insurance contract, or every individual or group 7
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 8
or renewed in this state that is required to cover licensed certified lactation counselor services 9
defined in subsection (a) of this section, shall report utilization and cost information related to 10
licensed certified lactation counselor services to the office of the health insurance commissioner on 11
or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 12
shall define the utilization and cost information required to be reported. 13
(d) This section shall not apply to insurance coverage providing benefits for: 14
(1) Hospital confinement indemnity; 15
(2) Disability income; 16
(3) Accident only; 17
(4) Long-term care; 18
(5) Medicare supplement; 19
(6) Limited benefit health; 20
(7) Specified disease indemnity; 21
(8) Sickness or bodily injury or death by accident or both; and 22
(9) Other limited benefit policies. 23
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 24
Corporations" is hereby amended by adding thereto the following section: 25
27-20-83. Licensed certified lactation counselor. 26
(a) As used in this section, “licensed certified lactation counselor” means a trained 27
professional who holds a licensure and certification by the department of health in accordance with 28
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 29
evaluation, problem identification, treatment, education, and consultation to provide lactation care 30
and services to childbearing families, and infant children from birth to twelve (12) months old 31
within the scope of practice pursuant to the provisions of § 23-13.8-9. 32
(b) Every individual or group health insurance contract, or every individual or group 33
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 34
LC001900 - Page 4 of 6
or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 1
lactation counselors in accordance with each health insurers' respective principles and mechanisms 2
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 3
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 4
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 5
care provider. No insurer or hospital or medical service corporation may require supervision, 6
signature, or referral by any other health care provider as a condition of reimbursement, except 7
when those requirements are also applicable to other categories of health care providers. No insurer 8
or hospital or medical service corporation or patient may be required to pay for duplicate services 9
actually rendered by both a licensed certified lactation counselor and any other health care provider. 10
(c) Every individual or group health insurance contract, or every individual or group 11
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 12
or renewed in this state that is required to cover licensed certified lactation counselor services 13
defined in subsection (a) of this section, shall report utilization and cost information related to 14
licensed certified lactation counselor services to the office of the health insurance commissioner on 15
or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 16
shall define the utilization and cost information required to be reported. 17
(d) This section shall not apply to insurance coverage providing benefits for: 18
(1) Hospital confinement indemnity; 19
(2) Disability income; 20
(3) Accident only; 21
(4) Long-term care; 22
(5) Medicare supplement; 23
(6) Limited benefit health; 24
(7) Specified disease indemnity; 25
(8) Sickness or bodily injury or death by accident or both; and 26
(9) Other limited benefit policies. 27
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 28
Organizations" is hereby amended by adding thereto the following section: 29
27-41-100. Licensed certified lactation counselor. 30
(a) As used in this section, “licensed certified lactation counselor” means a trained 31
professional who holds a licensure and certification by the department of health in accordance with 32
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 33
evaluation, problem identification, treatment, education, and consultation to provide lactation care 34
LC001900 - Page 5 of 6
and services to childbearing families, and infant children from birth to twelve (12) months old 1
within the scope of practice pursuant to the provisions of § 23-13.8-9. 2
(b) Every individual or group health insurance contract, or every individual or group 3
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 5
lactation counselors in accordance with each health insurers' respective principles and mechanisms 6
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 7
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 8
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 9
care provider. No insurer or hospital or medical service corporation may require supervision, 10
signature, or referral by any other health care provider as a condition of reimbursement, except 11
when those requirements are also applicable to other categories of health care providers. No insurer 12
or hospital or medical service corporation or patient may be required to pay for duplicate services 13
actually rendered by both a licensed certified lactation counselor and any other health care provider. 14
(c) Every individual or group health insurance contract, or every individual or group 15
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 16
or renewed in this state that is required to cover licensed certified lactation counselor services 17
defined in subsection (a) of this section, shall report utilization and cost information related to 18
licensed certified lactation counselor services to the office of the health insurance commissioner on 19
or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 20
shall define the utilization and cost information required to be reported. 21
(d) This section shall not apply to insurance coverage providing benefits for: 22
(1) Hospital confinement indemnity; 23
(2) Disability income; 24
(3) Accident only; 25
(4) Long-term care; 26
(5) Medicare supplement; 27
(6) Limited benefit health; 28
(7) Specified disease indemnity; 29
(8) Sickness or bodily injury or death by accident or both; and 30
(9) Other limited benefit policies. 31
SECTION 5. This act shall take effect on January 1, 2026. 32
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
***
This act would require health insurance policies to cover licensed certified lactation 1
counselor services for childbearing families. It would also prohibit requiring supervision or 2
duplicate payments for services and mandates annual reporting. 3
This act would take effect on January 1, 2026. 4
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