Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0705

Introduced
3/7/25  

Caption

Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.

Impact

The bill is expected to have a significant effect on healthcare delivery in the state, particularly for populations with chronic illnesses who may have difficulties accessing traditional healthcare services. By requiring insurance policies to accept community health workers without unnecessary barriers, such as requiring additional supervision or payment for duplicate services, S0705 aims to improve access to necessary care and promote better health outcomes for vulnerable populations. This could lead to a more streamlined approach to health management, enhancing the coordination of care and potentially reducing overall healthcare costs in the long run.

Summary

S0705 is a bill aimed at expanding health insurance coverage for community health worker services in Rhode Island. Introduced by a group of Senators, the bill defines community health workers as trained professionals who provide essential services to patients with chronic health conditions. These services may include health coaching, education, care planning, and system navigation, specifically tailored to assist patients facing barriers to their health needs. The legislation mandates that all health insurance policies issued or renewed after January 1, 2026, must cover services provided by community health workers, thereby integrating these roles into the broader healthcare delivery system.

Contention

However, the bill has generated some debate regarding the integration of community health workers within the existing healthcare framework. Advocates for the bill assert that this inclusion will reduce healthcare disparities and improve patient engagement, while critics may voice concerns regarding the quality control and standardization of services provided by community health workers. As the scope of health insurance policies expands, there are also discussions surrounding the additional costs to insurers and whether these costs will ultimately be passed on to consumers, sparking further analysis on the financial sustainability of the mandate.

Companion Bills

No companion bills found.

Previously Filed As

RI H5628

Mandates all health insurance contracts, plans, or policies provide the same reimbursement to independent healthcare facilities as that of hospital affiliated facilities where the same healthcare service is provided.

RI H5082

Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.

RI S0051

Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.

RI H6158

Mandates insurance coverage for scalp cooling treatments for breast cancer patients undergoing chemotherapy to prevent hair loss during chemotherapy treatments.

RI S0263

Requires coverage for acute mental health crisis mobile response and stabilization services to eligible individuals enrolled as plan beneficiaries.

RI H6118

Requires coverage for acute mental health crisis mobile response and stabilization services to eligible individuals enrolled as plan beneficiaries.

RI S0115

Requires health plans that provide prescription benefits to cover at least one type of glucagon auto-injector, nasal spray, or formulation that does not require reconstitution to treat hypoglycemia. No copayment or deductible would be required.

RI H5173

Requires health plans that provide prescription benefits to cover at least one type of glucagon auto-injector, nasal spray, or formulation that does not require reconstitution to treat hypoglycemia. No copayment or deductible would be required.

Similar Bills

RI H6117

Requires insurance coverage for all community health workers' services to include health and promotion coaching, health education and training, health system navigation and resource coordination services, care planning and follow-up care recommendations.

RI S0479

Requires health insurance plans to cover services provided by licensed certified professional midwives. Insurers must report utilization and cost data annually. Certain limited benefit policies are exempt.

RI S0116

Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.

RI H5119

Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.

RI H6119

Adds to the powers and duties of the OHIC the undertaking of analyses, reports, studies, and recommendations with respect to reimbursement and financing for the provision of primary care services to Rhode Islanders.

RI S0053

Provides an insurer would not impose prior authorization requirements for any service ordered by an in-network primary care provider.

RI H5120

Provides an insurer would not impose prior authorization requirements for any service ordered by an in-network primary care provider.

AR SB626

To Require Fair And Transparent Reimbursement Rates; To Ensure Parity Of Healthcare Services; To Amend The Billing In The Best Interest Of Patients Act; And To Declare An Emergency.