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.

Rhode Island Bill: Equitable Funding for Healthcare Provider Bad Debt

When a patient receives medical care, they are typically responsible for paying a portion of the bill out of pocket — through co-payments, co-insurance, or deductibles. Sometimes, despite a doctor's or hospital's best efforts to collect, patients simply don't pay these amounts. This bill addresses what happens in those situations by requiring health insurance companies to step in and cover at least 65% of those unpaid patient costs after a healthcare provider has made reasonable attempts to collect the money on their own.

The bill establishes a formal process for how this reimbursement would work. A healthcare provider — such as a doctor's office, clinic, or hospital — would need to demonstrate that they made genuine efforts to collect the unpaid amount from the patient before requesting compensation from the insurer. Once those reasonable collection efforts have been exhausted, the insurance company would be required to pay the provider at least 65 cents for every dollar the patient owed but didn't pay.

This bill primarily affects healthcare providers (who would receive greater financial protection against unpaid bills) and health insurance companies (who would take on new financial responsibility for patient bad debt). Patients themselves are not off the hook — they would still owe their share — but providers would have a safety net to recover most of what they're owed. The bill could also indirectly affect insurance premiums, since insurers taking on added costs sometimes pass those along to policyholders.

The bill has been introduced and referred to the Senate Health and Human Services Committee, where it will be reviewed before any further action is taken.