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Below is the relevant legislation related to parity that has been introduced during the current or recently adjourned legislative session. State parity legislation passed in any state since 2008 is usually designed to increase compliance with the federal law and to strengthen state laws.

Are we missing any passed or introduced legislation? Let us know at info@paritytrack.org.

Introduced Legislation

Regular Session 1/1/2019
Will Adjourn 12/31/2019
Governor's Deadline 1/10/2020

2019

Primary Focus Mandated Benefit: Residential and Inpatient
Title/Description Requires Insurance Coverage For At Least Ninety (90) Days Of Residential Or Inpatient Services For Mental Health And/Or Substance-Use Disorders For American Society Of Addiction Medicine Levels Of Care 3.1 And 3.3
Citation SB 26
Introduced 1/15/2019
Sponsor Sens. Crowley (D); Quezada (D); Goldin (D); Nesselbush (D); Metts (D)
Status Pending
Summary

SB 26 amends Section 27-38.2-1 of the General Laws to require group health plans and individual or group health insurance plans to provide at least 90 days of coverage for residential or inpatients services for the treatment of mental health and/or substance use disorders provided at ASAM levels of care 3.1 and 3.3.

2018

Primary Focus Medical Management Limitations; Medicaid
Title/Description Concerns privacy provisions and utilization review for residential and inpatient services
Citation S. 2545 Sub A
Introduced 3/2018
Sponsor Sen. Miller (D)
Summary

Section 1 amends RI General Laws §5-37.3-4 to allow SUD providers to reveal a patient’s protected health information to an individual if the provider believes this will prevent or lessen serious or imminent threats to the patient and the individual being told is reasonably able to lessen or prevent such a threat.
Section 4 amends §27-38.2-1a to require any contract between the RI Medicaid program and any insurance carrier provide equitable coverage for mental health and substance use disorder treatment.
Additionally, S.2545 Sub A requires group health plans, individual or group health insurance plans, and contracts between the Rhode Island Medicaid program and any health insurance carrier to provide equitable coverage of clinically appropriate residential or inpatient care, including detoxification and stabilization services, for the treatment of mental health and substance use disorder. Further guidelines create timelines for utilization review in which treatment plans can be submitted by providers upon an emergency admission or continuation of care and reviewed by the insurer. During the utilization review process, the patient should remain presumptively covered for residential and inpatient services.

Primary Focus Medical Management Limitations
Title/Description Concerns utilization review process for residential and inpatient services
Citation H 7476
Introduced 2/7/2018
Sponsor Rep. Serpa (D)
Status Died in Committee
Summary

H.7476 amends RI General Laws §27-38.2-1 to require group health plans or health insurers to provide equitable coverage for clinically appropriate residential or inpatient care, including detoxification and stabilization services, for the treatment of mental health and substance use disorders. Further guidelines create timelines in which treatment plans can be submitted for utilization review by providers upon an emergency admission or continuation of care. During the utilization review process, the patient should remain presumptively covered for residential and inpatient services.

Primary Focus Enforcement
Title/Description Requires the Health Insurance Commissioner submit recommendations to increase parity requirements
Citation H.7931
Introduced 3/7/2018
Sponsor Rep. Ranglin-Vaeell (D)
Status Died in Committee
Summary

H.7931 amends RI General Laws §42-14.5-3 to require the Health Insurance Commissioner to make recommendations to the General Assembly concerning mental health parity compliance. Such recommendations should include strategies to reduce unreasonable prior authorization and utilization review requirements, remediation provisions, telemedicine reimbursement rates, and cost sharing methodologies.

Primary Focus Mandated Benefit
Title/Description Requires coverage for annual pediatric mental health examination
Citation H.7810
Sponsor Rep. Bennett (D)
Status Died in Committee
Summary

H. 7810 amends RI General Laws to provide equitable coverage for annual pediatric mental health examinations when determined medically necessary and ordered by a physician for a child, 10 to 18 years old. H. 7810 amends RI General Laws §27-18-27.1, §27-19-18.1, §27-20-14.1, and §27-41-61.1 to apply the above to every individual or group hospital or medical expense insurance policy, individual or group hospital or medical services plan contract, nonprofit hospital/medical service corporation plan, or health maintenance organization contact.

Primary Focus Parity: General
Title/Description Clarifies the term drug addiction
Citation H. 7623
Introduced 2/14/2018
Sponsor Representatives Walsh, Williams, Regunberg, Lombardi, and Hull
Status Died in Committee
Summary

H. 7623 amends RI General Law §27-38.2-2 to define the term “drug addiction” as a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Additionally, H. 7623 amends §27-38.2-1 to include drug addiction in coverage requirements of said section for group health plans and individual or group health insurance plans.

Primary Focus Parity: General
Title/Description Prohibiting the use of co insurance for mental health and substance use disorder benefits
Citation H. 7359
Introduced 1/31/2018
Sponsor Rep. Blazejewski (D)
Status Died in Committee
Summary

H. 7359 amends RI General Laws by prohibiting insurers from imposing coinsurance charges on mental health and substance use disorder benefits.
H. 7359 amends RI General Laws §27-18-8, §27-19-7.2, §27-20-6.2, §27-41-29.2, §27-18-84, §27-19-76, §27-20-72, and §27-41-89 to apply the above to accident and sickness insurers, nonprofit hospital/medical service corporations, health maintenance organizations, individual or group hospital or medical expense insurance policy, or individual or group hospital or medical services plan contracts.
Section 5 amends §27-38.2-1 to exclude deductibles, copayments, and out of pocket maximums for mental health and substance use disorder benefits offered by group health plans and individual and group health insurance plans. It also requires quantitative treatment limitations be no more restrictive than those applied to medical conditions in each treatment classification.

Primary Focus Mandated Benefit: Length of Stay
Title/Description Mandates minimum coverage for residential or inpatient services for mental health and SUD treatment.
Citation S. 2128
Introduced 1/2018
Sponsor Sen. Crowley (D)
Status Died in Committee
Summary

S.2128 amends the RI General Laws §27-38.2-1 to require group health plans and individual or group health insurance plans provide coverage for at least 90 days of residential or inpatient services for mental health and SUD at specified ASAM levels of care.

Primary Focus Access to Services
Title/Description Adds state licensed facilities to definition of providers for purposes of prompt payment provisions.
Citation H.5844
Citation S.574
Introduced 3/2/2017
Sponsor Representative Tanzi (D); Senator DiPalma (D)
Status Died in Committee
Summary

This bill amends RI General Laws to include state licensed facilities that provide mental health and SUD services in the definition of health care providers for the purposes of prompt payment of health insurance claims. It also amends §27-18-61, §27-19-52, §27-20-47, and §27-41-64 to apply the above to accident and sickness insurance policies, nonprofit hospital/medical service corporations, and health maintenance organizations.

Primary Focus Mandated benefit: Length of Stay
Title/Description Prohibits denied coverage due to medical necessity criteria for continued residential or inpatient care
Citation S. 501
Introduced 3/2017
Sponsor Rep. Crowley (D)
Status Died in Committee
Summary

S.501 amends RI General Law §27-38.2-1 to prohibit group health plans and individual or group health insurance plans from denying continued residential or inpatient treatment coverage for mental health or substance use disorder services due to medical necessity criteria if the individual is currently in such treatment and the provider has recommended continued residential or inpatient treatment based upon a clinical assessment.

2017

H5218
Introduced 1/2017
Sponsor Reps. Serpa, Fellela, Jacquard, Ackerman, and Vella-Wilkinson
Status Dead 9/2017
Summary

This bill amends the section of state insurance law about behavioral health coverage by requiring Medicaid managed care organizations to cover mental health and substance use disorders under the same terms and conditions as other conditions. Additionally, the bill requires the coverage of in-network residential or inpatient services, including detoxification and stabilization services, when deemed clinically appropriate by a qualified professional provided that the professional submits a treatment plan to the insurer.

H5637
Senate S0268
Introduced 1/2017
Sponsor Reps. Blazejewski, Johnston, Keable, Diaz, and Bennett and Sens. Goldin, Miller, Satchell, Calkin, Sheehan
Status Dead 3/2017
Summary

Among other things, this bill amends the section of state insurance law about behavioral health coverage by prohibiting the use of financial requirements for behavioral health care.

H6299
Senate S0330
Introduced 6/2017
Sponsor Reps. Ranglin-Vassell and Blazejewski and Sens. Coyne, Miller, Crowley
Status Dead 6/2017
Summary

This bill amends a section of state law by requiring the health insurance commissioner to submit to the general assembly recommendations to ensure better compliance with state mental health parity requirements. Such recommendations must include general insurer compliance, prior authorization and utilization review, telemedicine reimbursement rates, and cost sharing methodologies.

S0150
Introduced 1/2017
Sponsor Sens. Crowley, Quezada, Metts, and Nesselbush
Status Dead 3/2017
Summary

 This bill amends the section of state insurance law about behavioral health coverage by requiring coverage of at least 90 days of inpatient or residential services for mental health and/or substance use disorders for levels of care 3.1 and 3.3 as dictated by the American Society of Addiction Medicine (click here to learn about ASAM levels of care).

S0329
Introduced 2/2017
Sponsor Sens. Miller, Goldin, Satchell, Sosnowski, Goodwin
Status Dead 4/2017
Summary

Summary: This bill amends the section of state insurance law about behavioral health coverage by specifying that providers must submit a treatment plan to insurers for the continued authorization of inpatient and residential behavioral health care but that individuals are still eligible for care during the authorization review process.

S0501
Introduced 3/2017
Sponsor Sens. Crowley, Sosnowski, Quezada, Goldin, and Miller
Status Dead 3/2017
Summary

This bill amends the section of state insurance law about behavioral health coverage by prohibiting the denial of coverage for continued residential or inpatient treatment if the patient has been admitted or is in residential or inpatient services and the provider has recommended continued mental health treatment based on clinical assessment, or for substance use disorders, based on criteria by the America Society of Addiction Medicine.

2016

H 7163
Introduced 1/2016
Sponsor Reps. Edwards, Canario, Bennett, Abney, Keable
Status Dead 6/2016
Summary

This bill amends a section of state law about parity by requiring health plans not require the use of a non-deterrent opioid analgesic drug prior to use of an abuse-deterrent product. It also requires that all health plans contain at least one abuse-deterrent product option within their drug formularies.

H 2774
Introduced 3/2016
Sponsor Reps. Nesselbush, Miller, Sheehan, Sosnowski, Coyne
Status Dead 6/2016
Summary

This bill amends a section of state law that impacts small employer health plans. It requires that all premiums, rebates, and cost-sharing discounts resulting from the participation in programs for health promotion must comply with the Federal Parity Law.

H 7617
Senate S 2461
Introduced 2/2016
Sponsor Reps. Bennett, Hull, Casey, Diaz, Slater and Sens. Miller, Satchell, Nesselbush, Coyne, and Sheehan
Status Dead 5/2016
Summary

This bill tries to change the section of the state insurance law about parity so that individuals do not have to use a non-abuse-deterrent opioid medication before they are prescribed an abuse-deterrent opioid medication.

H 7625
Senate S 2510
Introduced 2/2016
Sponsor Reps. Bennett, Hull, Casey, Diaz, Slater and Sens. Miller, Satchell, Nesselbush, Coyne, and Sheehan
Status Dead 6/2016
Summary

This bill amends a section of the state insurance law about parity so that health insurers cannot deny continued residential or inpatient treatment for mental health or substance use disorder if the patient is already admitted to residential or inpatient treatment and the provider recommends continued treatment in the facility based upon criteria from the American Society of Addiction Medicine.

H 7932
Senate S 2501
Introduced 2/2016
Sponsor Reps. Blazejewski, Keable, Johnston, Bennett, Diaz
Status Dead 3/2016
Summary This bill amends a section of state insurance law by eliminating the ability of health insurers to use financial requirements to control access to mental health and substance use disorder services.
S 2697
Introduced 3/2016
Sponsor Sen. Nesselbush
Status Dead 3/2016
Summary

This was a comprehensive bill that attempted to ensure the appropriate use of behavioral health services. The bill included the following sections related to network adequacy:

 

The bill also made the following amendments to the section of state law about coverage for the treatment of mental health and substance use disorders:

  • It added that coverage for mental health, substance use, and behavioral health disorders must be under the same terms and conditions as any other illness, particularly illnesses commonly treatment in primary care settings
  • It extended the definition of mental health or substance use disorders to include any health-related behavior identified by the director of health as having an effect on health, illness, disease or function, and that substantially limits an individual’s life activities
  • It added that medical necessity determinations must be made in a manner consistent with determinations used for other diseases, particularly illnesses commonly treated in primary care settings

The bill also requires the Office of the Health Insurance Commission to submit a report on how to improve compliance with the parity section of state law. The report can include sections on the following areas:

  • Provider payment strategies focusing on cost effective utilization of service, such as step down and diversion programs
  • Benefit design
  • New health care technology

The bill also required that copayments for behavioral health office visits must be equal to copayments for non-preventative primary care office visits.

2015

S 167
Introduced 2/2016
Sponsor Sens. Miller, Crowley, Sosnowski, Goldin, Jabour
Status Dead 6/2015
Summary This bill tried to change the section of the state insurance law about parity so that insurance plans would have to cover abuse-deterrent opioid medications.

2014

H 7970
Senate S 2769
Introduced 3/2014
Sponsor Reps. Ferri, Naughton, McNamara, Bennett, Cimini and Sens. Nesselbush, Miller, Sheehan, Sosnowski, Paiva Weed
Status Dead 3/2015
Summary

This comprehensive bill tried to change law in a number of ways relevant to parity:

  • Requires insurance plans to cover all screening and diagnostic services for behavioral health conditions
  • Allows the Director of the Department of Health to review plans’ utilization review procedures for behavioral health services to make sure that they are the same as those used for other medical services
  • Requires plans to use copayments for behavioral health services that are equal to “non-preventive primary care” office visit copayments
  • Specifies that “mental illness coverage” includes services from a behavioral health provider in a medical facility
  • Directs the Health Insurance Commissioner to enforce the Federal Parity Law
S 2701
Introduced 3/2014
Sponsor Reps. Cool Rumsey, Miller, Jabour, Sosnowski, Ottiano
Status Dead 3/2014
Summary

This bill tried to change the section of the state insurance law about parity in several ways:

HB 7933
Introduced 3/2014
Sponsor Reps. Bennett, Hull, Guthrie, Canario, Morin
Status Dead 4/2014
Summary

This bill tried to change the section of the state insurance law about parity. It would have required plans to cover the following prescription medications for substance use disorder treatment:

  • Naloxone
  • Methadone
  • Suboxone
  • Naltrexone
  • Buprenorphine

The bill also would have required the Health Insurance Commissioner to annually assess insurance plans’ compliance with these prescription medication coverage requirements.

The bill also tried to add another section to the state insurance law establishing standards for hospitals to follow when they discharge patients with substance use disorders.

H 7979
Introduced 3/2014
Sponsor Reps. Naughton, McNamara, Ferri, Shekarchi, Martin
Status Dead 5/2014
Summary This bill tried to change the section of the state insurance law about parity by removing the language that exempted plans from covering methadone maintenance treatment (a different bill did in fact accomplish this; S 2801, which is summarized above).
S 2534
House Bill H 7477
Introduced 2/2014
Sponsor Reps. Miller, Satchell, Picard, Goldin, and Jabour
Status Dead
Summary

This bill amended a section to the state insurance code by prohibiting health insurers from the following activities:

 

  • Requiring individuals use an opioid drug not approved by the FDA prior to using a non-opioid drug approved by the FDA
  • Requiring individuals use a non-abuse deterrent opioid prior to an abuse-deterrent opioid

2013

S 200
Introduced 2/2013
Sponsor Doyle, Gallo, Cool Rumsey
Status Dead 3/2013
Summary

This bill tried to change the section of the state insurance law about parity so that insurance plans would have to use the same criteria for determining reimbursement rates for behavioral health providers as the use for other medical providers.

H 5613
Introduced 2/2013
Sponsor Reps. Ajello, Handy, O`Grady, McNamara, Keable
Status Dead 4/2013
Summary

This bill tried to change the section of the state insurance law about parity in the following ways:

 

  • Requires plans to use the same criteria for determining reimbursement rates for behavioral health providers as the use for other medical providers
  • Removes language that exempted plans from covering methadone maintenance treatment for substance use disorders
  • Removes 30 day outpatient visit annual limit for behavioral health services
  • Removes 30 hour outpatient visit annual limit for substance use disorders along with 30 day annual limit for residential treatment and 30 day detoxification annual limit
  • Removes section requiring that all services take place within Rhode Island
  • Allows the Commissioner of Health Insurance to issue regulations about this section of the law
  • Requires the Commissioner of Health Insurance to make sure all state regulations are in compliance with what is required by the Federal Parity Law

(Many of these changes did in fact take place in later sessions and those changes are reflected in the summaries of relevant sections of Rhode Island law found at the bottom of this page under “Rhode Island Parity Law”.

2012

H 7785
Senate Bill S 2638
Introduced 3/2012
Sponsor Reps. Ajello, Blazejewski and Sens. Doyle, Tassoni, Gallo
Summary

This bill tried to change the section of the state insurance law about parity so that insurance plans would have to use the same criteria for determining reimbursement rates for mental health providers as they use for other medical providers.

S 2076
Introduced 1/2012
Sponsor Sens. O`Neill, Cote, Bates, Maher, Sosnowski
Status Dead 1/2012
Summary

This bill tried to change the section of the state insurance law about autism coverage to require coverage for psychiatry, psychology, and pharmaceutical services. The bill also tried to change some credentialing requirements for providers of applied behavioral analysis. In terms of how it would have affected the law about autism coverage, it is exactly the same as H 7165/S 2560 from the same session, which became law (summarized above).

2010

H 7361
Senate S 2551
Introduced 2/2010
Sponsor Reps. Ajello, Ruggiero, Fierro, Ferri, Walsh and Sens. Perry, Levesque, Gallo, Fogarty, Tassoni
Status Dead 3/2010
Summary

This bill tried to change the section of the state insurance law about parity so that insurance plans would have to use the same criteria for determining reimbursement rates for mental health providers as the use for other medical providers. Under no circumstances can mental health providers be reimbursed less than other medical providers of a similar level with similar expertise.

H 7260
Introduced 2/2010
Sponsor Reps. Palumbo, Naughton, Corvese, Jackson, Caprio
Status Dead 4/2110
Summary

This bill tried to add a section about autism coverage to the state insurance law. Here is how the bill is different than the current section of the insurance law about autism coverage, which was added in 2011 and is summarized at the bottom of this page:

 

  • Applies to small employer fully-insured plans and individual plans
  • Goes into much greater detail defining various forms of treatment
  • Lists “habilitative and rehabilitative care” and “therapeutic care” instead of “physical therapy”, “speech therapy”, and “occupational therapy”
  • Defines autism spectrum disorder as autistic disorder Asperger’s disorder, and pervasive developmental disorder not otherwise specified, as defined in the DSM
  • No annual maximum for applied behavior analysis
  • No age limit for coverage
  • Forbids annual limits for outpatient visits
  • Does not have any language about how often an insurance plan can review a child’s treatment plan
S 2422
Introduced 2/2010
Sponsor Sens. O`Neill, Pinga, Cote, Raptakis, Maher
Status Dead 5/2010
Summary

Among other things, this bill tried to add a section about autism coverage to the state insurance law. Here is how the bill is different than the current section of the insurance law about autism coverage, which was added in 2011 and is summarized at the bottom of this page:

2009

H 5537
Introduced 2/2009
Sponsor Reps. Dennigan, Mattiello, and McNamara
Status Dead
Summary This bill amended the state insurance law by requiring all health insurers cover services provided by nurse practitioners and psychiatric and mental health nurse clinical specialists. This bill is similar to H6274 and S471 from the same legislative session.
S 471
Introduced 2/2009
Sponsor Sen. Doyle
Status Dead
Summary This bill amended the state insurance law by requiring all health insurers cover services provided by nurse practitioners and psychiatric and mental health nurse clinical specialists. This bill is similar to H6274 and H 5537 from the same legislative session.
S 357
House H 6087
Sponsor Sens. Sosnowski, Walaska and Rep. Wasylyk
Status Dead 4/2009
Summary

This bill tried to change the section of the state insurance law about parity so that it specifically includes eating disorders (even though the law as written then and now does require plans to cover eating disorders).

S 6274
Introduced 6/2009
Sponsor Reps Dennigan and Fellela
Status Dead
Summary

This bill amended the state insurance law by requiring all health insurers cover services provided by nurse practitioners and psychiatric and mental health nurse clinical specialists. This bill is similar to H5537 and S 471 from the same legislative session.

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Common Violations

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