Charges the office of the health insurance commissioner to incorporate uncompensated care as a formula-driven numeric adjustment in the methodology used to establish any affordability standard or rate cap, applicable to hospital contracts.

Plain-English Summary

This bill would require Rhode Island's Office of the Health Insurance Commissioner (OHIC) — the state agency that oversees health insurance pricing — to formally factor in "uncompensated care" when setting limits on what health insurers can pay hospitals. Uncompensated care refers to medical services that hospitals provide to patients who cannot pay their bills, either because they are uninsured or underinsured. Currently, when OHIC sets affordability standards or rate caps for hospital contracts, this cost may not be systematically included in the calculation.

Under this bill, uncompensated care would need to be built into the formula using a specific, data-driven numeric adjustment — meaning it would be calculated in a consistent, measurable way rather than left to case-by-case judgment. This would apply to the contracts negotiated between health insurers and hospitals, which ultimately help determine what hospitals are paid and, indirectly, what consumers and employers pay in premiums.

The bill primarily affects hospitals, health insurance companies, and the state agency that regulates them. For hospitals, it could mean that the financial burden of treating patients who cannot pay is more formally recognized when payment rates are set. For insurers, it could influence the rates they are required to accept in contracts with hospitals. For everyday Rhode Islanders, the downstream effects could show up in health insurance premiums, though the extent of that impact would depend on how the formula is designed and applied.

The bill has been referred to the Senate Health and Human Services Committee and is scheduled for a hearing in April 2026, meaning it is still in the early stages of the legislative process.