Establishes a procedure for a health insurer to reimburse a healthcare provider no less than sixty-five percent (65%) of each unpaid co-payment, co-insurance or deductible amount due, after reasonable collection efforts.

Summary: Equitable Funding for Healthcare Provider Bad Debt

When a patient receives medical care, they are typically responsible for paying a portion of their bill out-of-pocket in the form of co-payments, co-insurance, or deductibles. Sometimes patients don't pay these amounts, leaving doctors, hospitals, and other healthcare providers with unpaid bills — a situation often called "bad debt." This bill addresses that problem by requiring health insurance companies to step in and cover a portion of those unpaid patient costs.

Under this bill, if a healthcare provider has made reasonable efforts to collect an unpaid co-payment, co-insurance, or deductible from a patient and still hasn't been paid, the patient's health insurer would be required to reimburse the provider at least 65% of the unpaid amount. The bill would establish a formal process outlining how and when providers can request this reimbursement from insurers.

This legislation primarily affects healthcare providers (such as doctors' offices, clinics, and hospitals) and health insurance companies operating in Rhode Island. Providers would gain a financial safety net when patients fail to pay their share of medical costs. Insurance companies would take on new financial obligations they don't currently have. Patients themselves are not directly penalized by this bill, though insurers could potentially factor these new costs into future premium pricing.

The bill has been introduced in the Rhode Island House and referred to the House Health & Human Services Committee before being transferred to the House Corporations Committee, meaning it is still in the early stages of the legislative process.