Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0690 Compare Versions

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

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5	5	2025 -- S 0690
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7	7	LC001582
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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: Senators Mack, Valverde, Murray, Lauria, Ujifusa, Kallman, Euer, de la
17	17	Cruz, DiMario, and Sosnowski
18	18	Date Introduced: March 07, 2025
19	19	Referred To: Senate Health & Human Services
20	20
21	21
22	22	It is enacted by the General Assembly as follows:
23	23	SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1
24	24	Policies" is hereby amended by adding thereto the following section: 2
25	25	27-18-95. Licensed certified lactation counselor. 3
26	26	(a) As used in this section, “licensed certified lactation counselor” means a trained 4
27	27	professional who holds a licensure and certification by the department of health in accordance with 5
28	28	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 6
29	29	evaluation, problem identification, treatment, education, and consultation to provide lactation care 7
30	30	and services to childbearing families, and infant children from birth to twelve (12) months old 8
31	31	within the scope of practice pursuant to the provisions of § 23-13.8-9. 9
32	32	(b) Every individual or group health insurance contract, or every individual or group 10
33	33	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 11
34	34	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 12
35	35	lactation counselors in accordance with each health insurers' respective principles and mechanisms 13
36	36	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 14
37	37	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 15
38	38	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 16
39	39	care provider. No insurer or hospital or medical service corporation may require supervision, 17
40	40	signature, or referral by any other health care provider as a condition of reimbursement, except 18
41	41	when those requirements are also applicable to other categories of health care providers. No insurer 19
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44	44	LC001582 - Page 2 of 6
45	45	or hospital or medical service corporation or patient may be required to pay for duplicate services 1
46	46	actually rendered by both a licensed certified lactation counselor and any other health care provider. 2
47	47	(c) Every individual or group health insurance contract, or every individual or group 3
48	48	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
49	49	or renewed in this state that is required to cover licensed certified lactation counselor services 5
50	50	defined in subsection (a) of this section, shall report utilization and cost information related to 6
51	51	licensed certified lactation counselor services to the office of the health insurance commissioner on 7
52	52	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 8
53	53	shall define the utilization and cost information required to be reported. 9
54	54	(d) This section shall not apply to insurance coverage providing benefits for: 10
55	55	(1) Hospital confinement indemnity; 11
56	56	(2) Disability income; 12
57	57	(3) Accident only; 13
58	58	(4) Long-term care; 14
59	59	(5) Medicare supplement; 15
60	60	(6) Limited benefit health; 16
61	61	(7) Specified disease indemnity; 17
62	62	(8) Sickness or bodily injury or death by accident or both; and 18
63	63	(9) Other limited benefit policies. 19
64	64	SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 20
65	65	Corporations" is hereby amended by adding thereto the following section: 21
66	66	27-19-87. Licensed certified lactation counselor. 22
67	67	(a) As used in this section, “licensed certified lactation counselor” means a trained 23
68	68	professional who holds a licensure and certification by the department of health in accordance with 24
69	69	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 25
70	70	evaluation, problem identification, treatment, education, and consultation to provide lactation care 26
71	71	and services to childbearing families, and infant children from birth to twelve (12) months old 27
72	72	within the scope of practice pursuant to the provisions of § 23-13.8-9. 28
73	73	(b) Every individual or group health insurance contract, or every individual or group 29
74	74	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 30
75	75	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 31
76	76	lactation counselors in accordance with each health insurers' respective principles and mechanisms 32
77	77	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 33
78	78	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 34
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80	80
81	81	LC001582 - Page 3 of 6
82	82	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 1
83	83	care provider. No insurer or hospital or medical service corporation may require supervision, 2
84	84	signature, or referral by any other health care provider as a condition of reimbursement, except 3
85	85	when those requirements are also applicable to other categories of health care providers. No insurer 4
86	86	or hospital or medical service corporation or patient may be required to pay for duplicate services 5
87	87	actually rendered by both a licensed certified lactation counselor and any other health care provider. 6
88	88	(c) Every individual or group health insurance contract, or every individual or group 7
89	89	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 8
90	90	or renewed in this state that is required to cover licensed certified lactation counselor services 9
91	91	defined in subsection (a) of this section, shall report utilization and cost information related to 10
92	92	licensed certified lactation counselor services to the office of the health insurance commissioner on 11
93	93	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 12
94	94	shall define the utilization and cost information required to be reported. 13
95	95	(d) This section shall not apply to insurance coverage providing benefits for: 14
96	96	(1) Hospital confinement indemnity; 15
97	97	(2) Disability income; 16
98	98	(3) Accident only; 17
99	99	(4) Long-term care; 18
100	100	(5) Medicare supplement; 19
101	101	(6) Limited benefit health; 20
102	102	(7) Specified disease indemnity; 21
103	103	(8) Sickness or bodily injury or death by accident or both; and 22
104	104	(9) Other limited benefit policies. 23
105	105	SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 24
106	106	Corporations" is hereby amended by adding thereto the following section: 25
107	107	27-20-83. Licensed certified lactation counselor. 26
108	108	(a) As used in this section, “licensed certified lactation counselor” means a trained 27
109	109	professional who holds a licensure and certification by the department of health in accordance with 28
110	110	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 29
111	111	evaluation, problem identification, treatment, education, and consultation to provide lactation care 30
112	112	and services to childbearing families, and infant children from birth to twelve (12) months old 31
113	113	within the scope of practice pursuant to the provisions of § 23-13.8-9. 32
114	114	(b) Every individual or group health insurance contract, or every individual or group 33
115	115	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 34
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119	119	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 1
120	120	lactation counselors in accordance with each health insurers' respective principles and mechanisms 2
121	121	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 3
122	122	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 4
123	123	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 5
124	124	care provider. No insurer or hospital or medical service corporation may require supervision, 6
125	125	signature, or referral by any other health care provider as a condition of reimbursement, except 7
126	126	when those requirements are also applicable to other categories of health care providers. No insurer 8
127	127	or hospital or medical service corporation or patient may be required to pay for duplicate services 9
128	128	actually rendered by both a licensed certified lactation counselor and any other health care provider. 10
129	129	(c) Every individual or group health insurance contract, or every individual or group 11
130	130	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 12
131	131	or renewed in this state that is required to cover licensed certified lactation counselor services 13
132	132	defined in subsection (a) of this section, shall report utilization and cost information related to 14
133	133	licensed certified lactation counselor services to the office of the health insurance commissioner on 15
134	134	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 16
135	135	shall define the utilization and cost information required to be reported. 17
136	136	(d) This section shall not apply to insurance coverage providing benefits for: 18
137	137	(1) Hospital confinement indemnity; 19
138	138	(2) Disability income; 20
139	139	(3) Accident only; 21
140	140	(4) Long-term care; 22
141	141	(5) Medicare supplement; 23
142	142	(6) Limited benefit health; 24
143	143	(7) Specified disease indemnity; 25
144	144	(8) Sickness or bodily injury or death by accident or both; and 26
145	145	(9) Other limited benefit policies. 27
146	146	SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 28
147	147	Organizations" is hereby amended by adding thereto the following section: 29
148	148	27-41-100. Licensed certified lactation counselor. 30
149	149	(a) As used in this section, “licensed certified lactation counselor” means a trained 31
150	150	professional who holds a licensure and certification by the department of health in accordance with 32
151	151	chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 33
152	152	evaluation, problem identification, treatment, education, and consultation to provide lactation care 34
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154	154
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156	156	and services to childbearing families, and infant children from birth to twelve (12) months old 1
157	157	within the scope of practice pursuant to the provisions of § 23-13.8-9. 2
158	158	(b) Every individual or group health insurance contract, or every individual or group 3
159	159	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 4
160	160	or renewed in this state on or after January 1, 2026, shall provide coverage for the services of 5
161	161	lactation counselors in accordance with each health insurers' respective principles and mechanisms 6
162	162	of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' 7
163	163	area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation 8
164	164	counselor practice act of 2024"), and are currently reimbursed when rendered by any other health 9
165	165	care provider. No insurer or hospital or medical service corporation may require supervision, 10
166	166	signature, or referral by any other health care provider as a condition of reimbursement, except 11
167	167	when those requirements are also applicable to other categories of health care providers. No insurer 12
168	168	or hospital or medical service corporation or patient may be required to pay for duplicate services 13
169	169	actually rendered by both a licensed certified lactation counselor and any other health care provider. 14
170	170	(c) Every individual or group health insurance contract, or every individual or group 15
171	171	hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 16
172	172	or renewed in this state that is required to cover licensed certified lactation counselor services 17
173	173	defined in subsection (a) of this section, shall report utilization and cost information related to 18
174	174	licensed certified lactation counselor services to the office of the health insurance commissioner on 19
175	175	or before July 1, 2026 and each July 1 thereafter. The office of the health insurance commissioner 20
176	176	shall define the utilization and cost information required to be reported. 21
177	177	(d) This section shall not apply to insurance coverage providing benefits for: 22
178	178	(1) Hospital confinement indemnity; 23
179	179	(2) Disability income; 24
180	180	(3) Accident only; 25
181	181	(4) Long-term care; 26
182	182	(5) Medicare supplement; 27
183	183	(6) Limited benefit health; 28
184	184	(7) Specified disease indemnity; 29
185	185	(8) Sickness or bodily injury or death by accident or both; and 30
186	186	(9) Other limited benefit policies. 31
187	187	SECTION 5. This act shall take effect on January 1, 2026. 32
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194	194	EXPLANATION
195	195	BY THE LEGISLATIVE COUNCIL
196	196	OF
197	197	A N A C T
198	198	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
199	199	***
200	200	This act would require health insurance policies to cover licensed certified lactation 1
201	201	counselor services for childbearing families. It would also prohibit requiring supervision or 2
202	202	duplicate payments for services and mandates annual reporting. 3
203	203	This act would take effect on January 1, 2026. 4
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