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| 4 | 4 | | |
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| 5 | 5 | | 2025 -- S 0479 |
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| 6 | 6 | | ======== |
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| 7 | 7 | | LC001585 |
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| 8 | 8 | | ======== |
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| 9 | 9 | | S T A T E O F R H O D E I S L A N D |
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| 10 | 10 | | IN GENERAL ASSEMBLY |
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| 11 | 11 | | JANUARY SESSION, A.D. 2025 |
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| 12 | 12 | | ____________ |
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| 13 | 13 | | |
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| 14 | 14 | | A N A C T |
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| 15 | 15 | | RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES |
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| 16 | 16 | | Introduced By: Senators Mack, Vargas, Kallman, Murray, Lauria, Acosta, Urso, |
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| 17 | 17 | | Valverde, Quezada, and DiMario |
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| 18 | 18 | | Date Introduced: February 26, 2025 |
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| 19 | 19 | | Referred To: Senate Health & Human Services |
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| 20 | 20 | | |
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| 21 | 21 | | |
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| 22 | 22 | | It is enacted by the General Assembly as follows: |
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| 23 | 23 | | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1 |
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| 24 | 24 | | Policies" is hereby amended by adding thereto the following section: 2 |
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| 25 | 25 | | 27-18-95. Certified professional midwife. 3 |
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| 26 | 26 | | (a) As used in this section, “certified professional midwife” or “CPM” means a trained 4 |
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| 27 | 27 | | professional who has successfully completed an accredited educational program in midwifery, 5 |
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| 28 | 28 | | holds a current certification as a certified professional midwife by the North American Registry of 6 |
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| 29 | 29 | | Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery 7 |
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| 30 | 30 | | in accordance with § 23-13-9. 8 |
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| 31 | 31 | | (b) Every individual or group health insurance contract, or every individual or group 9 |
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| 32 | 32 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 10 |
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| 33 | 33 | | or renewed in this state on or after January 1, 2026, shall provide coverage for the services of a 11 |
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| 34 | 34 | | certified professional midwife in accordance with each health insurers' respective principles and 12 |
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| 35 | 35 | | mechanisms of reimbursement, credentialing, and contracting, if the services are within the 13 |
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| 36 | 36 | | certified professional midwife’s area of professional competence as defined by the standard 14 |
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| 37 | 37 | | developed and maintained by the Midwives Alliance of North America (hereinafter referred to in 15 |
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| 38 | 38 | | this section as “MANA”) in collaboration with the department of health, and are currently 16 |
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| 39 | 39 | | reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical 17 |
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| 40 | 40 | | service corporation may require supervision, signature, or referral by any other healthcare provider 18 |
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| 41 | 41 | | as a condition of reimbursement, except when those requirements are also applicable to other 19 |
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| 42 | 42 | | |
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| 43 | 43 | | |
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| 44 | 44 | | LC001585 - Page 2 of 7 |
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| 45 | 45 | | categories of healthcare providers. No insurer or hospital or medical service corporation or patient 1 |
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| 46 | 46 | | shall be required to pay for duplicate services actually rendered by both a licensed certified 2 |
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| 47 | 47 | | professional midwife and any other healthcare provider. 3 |
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| 48 | 48 | | (c) Every individual or group health insurance contract, or every individual or group 4 |
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| 49 | 49 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 5 |
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| 50 | 50 | | or renewed in this state that is required to cover certified professional midwife services defined in 6 |
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| 51 | 51 | | subsections (a) and (b) of this section, shall report utilization and cost information related to 7 |
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| 52 | 52 | | licensed certified professional midwife’s services to the office of the health insurance 8 |
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| 53 | 53 | | commissioner on or before July 1, 2026 and each July 1 thereafter. The office of the health 9 |
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| 54 | 54 | | insurance commissioner shall define the utilization and cost information required to be reported. 10 |
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| 55 | 55 | | (d) This section shall not apply to insurance coverage providing benefits for: 11 |
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| 56 | 56 | | (1) Hospital confinement indemnity; 12 |
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| 57 | 57 | | (2) Disability income; 13 |
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| 58 | 58 | | (3) Accident only; 14 |
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| 59 | 59 | | (4) Long-term care; 15 |
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| 60 | 60 | | (5) Medicare supplement; 16 |
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| 61 | 61 | | (6) Limited benefit health; 17 |
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| 62 | 62 | | (7) Specified disease indemnity; 18 |
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| 63 | 63 | | (8) Sickness or bodily injury or death by accident or both; and 19 |
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| 64 | 64 | | (9) Other limited benefit policies. 20 |
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| 65 | 65 | | (e) Notwithstanding any general or special law to the contrary, unless otherwise specified, 21 |
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| 66 | 66 | | the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent 22 |
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| 67 | 67 | | laws, including general laws, special laws, or local laws, or any rule or regulation of the state 23 |
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| 68 | 68 | | including, but not limited to, §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or 24 |
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| 69 | 69 | | regulation. 25 |
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| 70 | 70 | | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 26 |
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| 71 | 71 | | Corporations" is hereby amended by adding thereto the following section: 27 |
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| 72 | 72 | | 27-19-87. Certified professional midwife. 28 |
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| 73 | 73 | | (a) As used in this section, “certified professional midwife” or “CPM” means a trained 29 |
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| 74 | 74 | | professional who has successfully completed an accredited educational program in midwifery, 30 |
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| 75 | 75 | | holds a current certification as a certified professional midwife by the North American Registry of 31 |
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| 76 | 76 | | Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery 32 |
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| 77 | 77 | | in accordance with § 23-13-9. 33 |
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| 78 | 78 | | (b) Every individual or group health insurance contract, or every individual or group 34 |
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| 79 | 79 | | |
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| 80 | 80 | | |
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| 81 | 81 | | LC001585 - Page 3 of 7 |
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| 82 | 82 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 1 |
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| 83 | 83 | | or renewed in this state on or after January 1, 2026, shall provide coverage for the services of a 2 |
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| 84 | 84 | | certified professional midwife in accordance with each health insurers' respective principles and 3 |
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| 85 | 85 | | mechanisms of reimbursement, credentialing, and contracting, if the services are within the 4 |
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| 86 | 86 | | certified professional midwife’s area of professional competence as defined by the standard 5 |
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| 87 | 87 | | developed and maintained by the Midwives Alliance of North America (hereinafter referred to in 6 |
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| 88 | 88 | | this section as “MANA”) in collaboration with the department of health, and are currently 7 |
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| 89 | 89 | | reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical 8 |
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| 90 | 90 | | service corporation may require supervision, signature, or referral by any other healthcare provider 9 |
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| 91 | 91 | | as a condition of reimbursement, except when those requirements are also applicable to other 10 |
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| 92 | 92 | | categories of healthcare providers. No insurer or hospital or medical service corporation or patient 11 |
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| 93 | 93 | | shall be required to pay for duplicate services actually rendered by both a licensed certified 12 |
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| 94 | 94 | | professional midwife and any other healthcare provider. 13 |
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| 95 | 95 | | (c) Every individual or group health insurance contract, or every individual or group 14 |
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| 96 | 96 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 15 |
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| 97 | 97 | | or renewed in this state that is required to cover certified professional midwife services defined in 16 |
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| 98 | 98 | | subsections (a) and (b) of this section, shall report utilization and cost information related to 17 |
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| 99 | 99 | | licensed certified professional midwife’s services to the office of the health insurance 18 |
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| 100 | 100 | | commissioner on or before July 1, 2026 and each July 1 thereafter. The office of the health 19 |
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| 101 | 101 | | insurance commissioner shall define the utilization and cost information required to be reported. 20 |
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| 102 | 102 | | (d) This section shall not apply to insurance coverage providing benefits for: 21 |
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| 103 | 103 | | (1) Hospital confinement indemnity; 22 |
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| 104 | 104 | | (2) Disability income; 23 |
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| 105 | 105 | | (3) Accident only; 24 |
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| 106 | 106 | | (4) Long-term care; 25 |
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| 107 | 107 | | (5) Medicare supplement; 26 |
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| 108 | 108 | | (6) Limited benefit health; 27 |
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| 109 | 109 | | (7) Specified disease indemnity; 28 |
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| 110 | 110 | | (8) Sickness or bodily injury or death by accident or both; and 29 |
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| 111 | 111 | | (9) Other limited benefit policies. 30 |
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| 112 | 112 | | (e) Notwithstanding any general or special law to the contrary, unless otherwise specified, 31 |
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| 113 | 113 | | the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent 32 |
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| 114 | 114 | | laws, including general laws, special laws, or local laws, or any rule or regulation of the state 33 |
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| 115 | 115 | | including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or 34 |
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| 116 | 116 | | |
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| 117 | 117 | | |
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| 118 | 118 | | LC001585 - Page 4 of 7 |
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| 119 | 119 | | regulation. 1 |
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| 120 | 120 | | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 2 |
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| 121 | 121 | | Corporations" is hereby amended by adding thereto the following section: 3 |
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| 122 | 122 | | 27-20-83. Certified professional midwife. 4 |
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| 123 | 123 | | (a) As used in this section, “certified professional midwife” or “CPM” means a trained 5 |
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| 124 | 124 | | professional who has successfully completed an accredited educational program in midwifery, 6 |
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| 125 | 125 | | holds a current certification as a certified professional midwife by the North American Registry of 7 |
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| 126 | 126 | | Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery 8 |
|---|
| 127 | 127 | | in accordance with § 23-13-9. 9 |
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| 128 | 128 | | (b) Every individual or group health insurance contract, or every individual or group 10 |
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| 129 | 129 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 11 |
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| 130 | 130 | | or renewed in this state on or after January 1, 2026, shall provide coverage for the services of a 12 |
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| 131 | 131 | | certified professional midwife in accordance with each health insurers' respective principles and 13 |
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| 132 | 132 | | mechanisms of reimbursement, credentialing, and contracting, if the services are within the 14 |
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| 133 | 133 | | certified professional midwife’s area of professional competence as defined by the standard 15 |
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| 134 | 134 | | developed and maintained by the Midwives Alliance of North America (hereinafter referred to in 16 |
|---|
| 135 | 135 | | this section as “MANA”) in collaboration with the department of health, and are currently 17 |
|---|
| 136 | 136 | | reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical 18 |
|---|
| 137 | 137 | | service corporation may require supervision, signature, or referral by any other healthcare provider 19 |
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| 138 | 138 | | as a condition of reimbursement, except when those requirements are also applicable to other 20 |
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| 139 | 139 | | categories of healthcare providers. No insurer or hospital or medical service corporation or patient 21 |
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| 140 | 140 | | shall be required to pay for duplicate services actually rendered by both a licensed certified 22 |
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| 141 | 141 | | professional midwife and any other healthcare provider. 23 |
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| 142 | 142 | | (c) Every individual or group health insurance contract, or every individual or group 24 |
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| 143 | 143 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 25 |
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| 144 | 144 | | or renewed in this state that is required to cover certified professional midwife services defined in 26 |
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| 145 | 145 | | subsections (a) and (b) of this section, shall report utilization and cost information related to 27 |
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| 146 | 146 | | licensed certified professional midwife’s services to the office of the health insurance 28 |
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| 147 | 147 | | commissioner on or before July 1, 2026 and each July 1 thereafter. The office of the health 29 |
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| 148 | 148 | | insurance commissioner shall define the utilization and cost information required to be reported. 30 |
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| 149 | 149 | | (d) This section shall not apply to insurance coverage providing benefits for: 31 |
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| 150 | 150 | | (1) Hospital confinement indemnity; 32 |
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| 151 | 151 | | (2) Disability income; 33 |
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| 152 | 152 | | (3) Accident only; 34 |
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| 153 | 153 | | |
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| 154 | 154 | | |
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| 155 | 155 | | LC001585 - Page 5 of 7 |
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| 156 | 156 | | (4) Long-term care; 1 |
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| 157 | 157 | | (5) Medicare supplement; 2 |
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| 158 | 158 | | (6) Limited benefit health; 3 |
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| 159 | 159 | | (7) Specified disease indemnity; 4 |
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| 160 | 160 | | (8) Sickness or bodily injury or death by accident or both; and 5 |
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| 161 | 161 | | (9) Other limited benefit policies. 6 |
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| 162 | 162 | | (e) Notwithstanding any general or special law to the contrary, unless otherwise specified, 7 |
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| 163 | 163 | | the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent 8 |
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| 164 | 164 | | laws, including general laws, special laws, or local laws, or any rule or regulation of the state 9 |
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| 165 | 165 | | including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or 10 |
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| 166 | 166 | | regulation. 11 |
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| 167 | 167 | | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 12 |
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| 168 | 168 | | Organizations" is hereby amended by adding thereto the following section: 13 |
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| 169 | 169 | | 27-41-100. Certified professional midwife. 14 |
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| 170 | 170 | | (a) As used in this section, “certified professional midwife” or “CPM” means a trained 15 |
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| 171 | 171 | | professional who has successfully completed an accredited educational program in midwifery, 16 |
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| 172 | 172 | | holds a current certification as a certified professional midwife by the North American Registry of 17 |
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| 173 | 173 | | Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery 18 |
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| 174 | 174 | | in accordance with § 23-13-9. 19 |
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| 175 | 175 | | (b) Every individual or group health insurance contract, or every individual or group 20 |
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| 176 | 176 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 21 |
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| 177 | 177 | | or renewed in this state on or after January 1, 2026, shall provide coverage for the services of a 22 |
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| 178 | 178 | | certified professional midwife in accordance with each health insurers' respective principles and 23 |
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| 179 | 179 | | mechanisms of reimbursement, credentialing, and contracting, if the services are within the 24 |
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| 180 | 180 | | certified professional midwife’s area of professional competence as defined by the standard 25 |
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| 181 | 181 | | developed and maintained by the Midwives Alliance of North America (hereinafter referred to in 26 |
|---|
| 182 | 182 | | this section as “MANA”) in collaboration with the department of health, and are currently 27 |
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| 183 | 183 | | reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical 28 |
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| 184 | 184 | | service corporation may require supervision, signature, or referral by any other healthcare provider 29 |
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| 185 | 185 | | as a condition of reimbursement, except when those requirements are also applicable to other 30 |
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| 186 | 186 | | categories of healthcare providers. No insurer or hospital or medical service corporation or patient 31 |
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| 187 | 187 | | shall be required to pay for duplicate services actually rendered by both a licensed certified 32 |
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| 188 | 188 | | professional midwife and any other healthcare provider. 33 |
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| 189 | 189 | | (c) Every individual or group health insurance contract, or every individual or group 34 |
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| 190 | 190 | | |
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| 191 | 191 | | |
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| 192 | 192 | | LC001585 - Page 6 of 7 |
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| 193 | 193 | | hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 1 |
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| 194 | 194 | | or renewed in this state that is required to cover certified professional midwife services defined in 2 |
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| 195 | 195 | | subsections (a) and (b) of this section, shall report utilization and cost information related to 3 |
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| 196 | 196 | | licensed certified professional midwife’s services to the office of the health insurance 4 |
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| 197 | 197 | | commissioner on or before July 1, 2026 and each July 1 thereafter. The office of the health 5 |
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| 198 | 198 | | insurance commissioner shall define the utilization and cost information required to be reported. 6 |
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| 199 | 199 | | (d) This section shall not apply to insurance coverage providing benefits for: 7 |
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| 200 | 200 | | (1) Hospital confinement indemnity; 8 |
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| 201 | 201 | | (2) Disability income; 9 |
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| 202 | 202 | | (3) Accident only; 10 |
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| 203 | 203 | | (4) Long-term care; 11 |
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| 204 | 204 | | (5) Medicare supplement; 12 |
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| 205 | 205 | | (6) Limited benefit health; 13 |
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| 206 | 206 | | (7) Specified disease indemnity; 14 |
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| 207 | 207 | | (8) Sickness or bodily injury or death by accident or both; and 15 |
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| 208 | 208 | | (9) Other limited benefit policies. 16 |
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| 209 | 209 | | (e) Notwithstanding any general or special law to the contrary, the provisions of this 17 |
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| 210 | 210 | | chapter shall supersede and shall control over any conflicting or inconsistent laws, including 18 |
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| 211 | 211 | | general laws, special laws, or local laws, or any rule or regulation of the state including, but not 19 |
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| 212 | 212 | | limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation. 20 |
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| 213 | 213 | | SECTION 5. This act shall take effect on January 1, 2026. 21 |
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| 214 | 214 | | ======== |
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| 215 | 215 | | LC001585 |
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| 216 | 216 | | ======== |
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| 217 | 217 | | |
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| 218 | 218 | | |
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| 219 | 219 | | LC001585 - Page 7 of 7 |
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| 220 | 220 | | EXPLANATION |
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| 221 | 221 | | BY THE LEGISLATIVE COUNCIL |
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| 222 | 222 | | OF |
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| 223 | 223 | | A N A C T |
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| 224 | 224 | | RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES |
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| 225 | 225 | | *** |
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| 226 | 226 | | This bill would require health insurance plans to cover services provided by licensed 1 |
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| 227 | 227 | | certified professional midwives. Insurers would be required to report utilization and cost data 2 |
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| 228 | 228 | | annually and certain limited benefit policies would be exempt. 3 |
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| 229 | 229 | | This act would take effect on January 1, 2026. 4 |
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| 230 | 230 | | ======== |
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| 231 | 231 | | LC001585 |
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| 232 | 232 | | ======== |
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| 233 | 233 | | |
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