Prohibits insurance companies from paying a rate that is less than the approved Medicaid rate set by the executive office of health and human services.

Plain-English Summary

This bill would set a minimum payment floor for what private insurance companies must pay healthcare providers in Rhode Island. Specifically, it would require that private insurers pay doctors, hospitals, and other healthcare providers at least as much as Medicaid pays for the same services. Medicaid rates are set by the state's Executive Office of Health and Human Services, and under this bill, no private insurance company could pay a provider less than those established rates.

This bill would affect several groups. Healthcare providers — such as doctors, clinics, and hospitals — could benefit by receiving higher payments from private insurers, since Medicaid rates are sometimes used as a baseline that private insurers currently pay below in certain cases. Private insurance companies would be directly impacted, as they could no longer negotiate reimbursement rates below the Medicaid floor. Patients and employers who pay insurance premiums could also be indirectly affected, since changes in what insurers pay providers may influence overall insurance costs.

Currently, the bill has been introduced and referred to the House Health & Human Services Committee, which has recommended it be held for further study. This means the bill has not moved forward yet and remains under review by lawmakers. No final action has been taken on it at this time.