§ 27-41-36. Services of midwives. Every health maintenance organization plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for the services of licensed midwives in accordance with each health maintenance organization’s respective principles and mechanisms of reimbursement, credentialing, and contracting if the services are within the licensed midwives’ area of […]
§ 27-41-37. Discontinuance of coverage — Chronic disabilities. No health maintenance organization subject to the provisions of this chapter shall discontinue reimbursement for or providing services for covered health care services of chronic disabilities, unless the patient has exhausted benefits to which he or she is entitled under the basic subscriber agreement, or unless it […]
§ 27-41-38. Drug coverage. No health maintenance organization that provides coverage for prescription drugs under a group plan master contract delivered, issued for delivery, or renewed in this state may require any person covered under the contract to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for the drugs. […]
§ 27-41-38.1. Medication synchronization. (a) An individual or group health insurance plan or policy delivered, issued for delivery, or renewed in this state on or after January 1, 2017, providing prescription drug coverage in the state, must permit and apply a prorated daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed […]
§ 27-41-38.2. Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies. (a) Definitions. As used herein: (1) “Maximum-allowable cost” or “MAC” means the maximum amount that a pharmacy benefits manager will reimburse toward the cost of a drug; (2) “Nationally available” means that there is an adequate supply available from regional […]
§ 27-41-39. Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists. (a) Every individual or group policy or contract delivered, issued for delivery, or renewed by a health maintenance organization in this state shall provide coverage for the services of certified registered nurse practitioners, practicing collaboratively and psychiatric and mental health nurse […]
§ 27-41-4. Issuance of license. (a)(1) Upon receipt of an application for issuance of a license, the director shall transmit copies of the application and accompanying documents to the director of health; (2) The director of health shall determine whether the applicant for a license, with respect to health care services to be furnished: (i) […]
§ 27-41-40. Certified counselors in mental health and therapists in marriage and family practice. (a) Every individual or group policy or contract delivered, issued for delivery or renewed by a health maintenance organization in this state shall, when deemed medically necessary by the health maintenance organization in accordance with its standard medical management protocols as […]
§ 27-41-41. Repealed. History of Section.P.L. 1994, ch. 301, § 4; P.L. 2002, ch. 292, § 85; Repealed by P.L. 2012, ch. 256, § 17; P.L. 2012, ch. 262, § 17, effective June 18, 2012. For comparable provisions, see § 27-41-77.
§ 27-41-41.1. Repealed. History of Section.P.L. 1994, ch. 301, § 4; Repealed by P.L. 2012, ch. 256, § 17; P.L. 2012, ch. 262, § 17, effective June 18, 2012. For comparable provisions, see § 27-41-77.
§ 27-41-41.2. Repealed. History of Section.P.L. 1994, ch. 301, § 4; P.L. 1997, ch. 51, § 4; P.L. 1997, ch. 92, § 4; P.L. 1999, ch. 134, § 4; Repealed by P.L. 2012, ch. 256, § 17; P.L. 2012, ch. 262, § 17, effective June 18, 2012. For comparable provisions, see § 27-41-77.
§ 27-41-41.3. Repealed. History of Section.P.L. 1994, ch. 301, § 4; Repealed by P.L. 2012, ch. 256, § 17; P.L. 2012, ch. 262, § 17, effective June 18, 2012. For comparable provisions, see § 27-41-77.
§ 27-41-42. Repealed.
§ 27-41-43. Mastectomy treatment. (a) All individual or group health insurance coverage and health-benefit plans delivered, issued for delivery, or renewed in this state on or after January 1, 2005, that provide medical and surgical benefits with respect to mastectomy shall provide, in a case of any person covered in the individual market or covered […]
§ 27-41-43.1. Insurance coverage for mastectomy hospital stays. (a) The Rhode Island general assembly recognizes that breast cancer is a unique illness with both a physical and emotional impact on patients. Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for a […]
§ 27-41-44. Diabetes treatment. (a) Every individual or group health insurance contract, plan, or policy delivered, issued for delivery or renewed in this state which provides medical coverage that includes coverage for physician services in a physician’s office and every policy which provides major medical or similar comprehensive-type coverage shall include coverage for the following […]
§ 27-41-45. Primary and preventive obstetric and gynecological care. Any insurer or nonprofit health service plan that provides obstetric and gynecological care for issuance or delivery in the state to any group or individual on an expense-incurred basis, including a health maintenance organization shall permit a woman to receive an annual visit to an in-network […]
§ 27-41-45.1. Hysterectomy or myomectomy treatment. Commencing January 1, 2023, any insurer or healthcare plan, nonprofit health medical service plan, or nonprofit hospital service plan that provides coverage for obstetric and gynecological care for issuance or delivery in the state to any group or individual on an expense-incurred basis, including a health plan offered by […]
§ 27-41-46. Whistleblowers protection. No health maintenance organizations pursuant to this chapter or any other insurer offering and/or insuring health services on a prepaid basis as defined in § 42-62-4(7) shall engage in any retaliation or retribution, directly or indirectly, or shall terminate or modify the terms of a medical service agreement that it maintains […]
§ 27-41-47. Penalties and remedies. (a) Any person, firm, corporation, association or other legal entity who or which shall violate the provisions of § 27-41-46 shall be guilty of a misdemeanor, and upon conviction, shall be fined in an amount of not more than one thousand dollars ($1,000), imprisonment for up to one year, or […]
