INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES, the official text

H7277 2026 -- H 7277 ======== LC004236 ======== STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2026 ____________ A N A C T RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES Introduced By: Representatives Stewart, Donovan, Boylan, Hopkins, Cotter, Caldwell, Fogarty, Cruz, Giraldo, and Place Date Introduced: January 23, 2026 Referred To: House Health & Human Services It is enacted by the General Assembly as follows: 1 SECTION 1. Chapter 27-18 of the General Laws entitled Accident and Sickness Insurance 2 Policies is hereby amended by adding thereto the following section: 3 27-18-96. Licensed certified lactation counselor. 4 (a) As used in this section, “licensed certified lactation counselor” means a trained 5 professional who holds a licensure and certification by the department of health in accordance with 6 chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 7 evaluation, problem identification, treatment, education, and consultation to provide lactation care 8 and services to childbearing families, and infant children from birth to twelve (12) months old 9 within the scope of practice pursuant to the provisions of § 23-13.8-9. 10 (b) Every individual or group health insurance contract, or every individual or group 11 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 12 or renewed in this state on or after January 1, 2027, shall provide coverage for the services of 13 lactation counselors in accordance with each health insurers respective principles and mechanisms 14 of reimbursement, credentialing, and contracting, if the services are within the lactation counselors 15 area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ( lactation 16 counselor practice act of 2024 ), and are currently reimbursed when rendered by any other health 17 care provider. No insurer or hospital or medical service corporation may require supervision, 18 signature, or referral by any other health care provider as a condition of reimbursement, except 19 when those requirements are also applicable to other categories of health care providers. No insurer 1 or hospital or medical service corporation or patient may be required to pay for duplicate services 2 actually rendered by both a licensed certified lactation counselor and any other health care provider. 3 (c) Every individual or group health insurance contract, or every individual or group 4 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 5 or renewed in this state that is required to cover licensed certified lactation counselor services 6 defined in subsection (a) of this section, shall report utilization and cost information related to 7 licensed certified lactation counselor services to the office of the health insurance commissioner on 8 or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner 9 shall define the utilization and cost information required to be reported. 10 (d) This section shall not apply to insurance coverage providing benefits for: 11 (1) Hospital confinement indemnity; 12 (2) Disability income; 13 (3) Accident only; 14 (4) Long-term care; 15 (5) Medicare supplement; 16 (6) Limited benefit health; 17 (7) Specified disease indemnity; 18 (8) Sickness or bodily injury or death by accident or both; and 19 (9) Other limited benefit policies. 20 SECTION 2. Chapter 27-19 of the General Laws entitled Nonprofit Hospital Service 21 Corporations is hereby amended by adding thereto the following section: 22 27-19-88. Licensed certified lactation counselor. 23 (a) As used in this section, “licensed certified lactation counselor” means a trained 24 professional who holds a licensure and certification by the department of health in accordance with 25 chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 26 evaluation, problem identification, treatment, education, and consultation to provide lactation care 27 and services to childbearing families, and infant children from birth to twelve (12) months old 28 within the scope of practice pursuant to the provisions of § 23-13.8-9. 29 (b) Every individual or group health insurance contract, or every individual or group 30 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 31 or renewed in this state on or after January 1, 2027, shall provide coverage for the services of 32 lactation counselors in accordance with each health insurers respective principles and mechanisms 33 of reimbursement, credentialing, and contracting, if the services are within the lactation counselors 34 area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ( lactation LC004236 - Page 2 of 6 1 counselor practice act of 2024 ), and are currently reimbursed when rendered by any other health 2 care provider. No insurer or hospital or medical service corporation may require supervision, 3 signature, or referral by any other health care provider as a condition of reimbursement, except 4 when those requirements are also applicable to other categories of health care providers. No insurer 5 or hospital or medical service corporation or patient may be required to pay for duplicate services 6 actually rendered by both a licensed certified lactation counselor and any other health care provider. 7 (c) Every individual or group health insurance contract, or every individual or group 8 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 9 or renewed in this state that is required to cover licensed certified lactation counselor services 10 defined in subsection (a) of this section, shall report utilization and cost information related to 11 licensed certified lactation counselor services to the office of the health insurance commissioner on 12 or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner 13 shall define the utilization and cost information required to be reported. 14 (d) This section shall not apply to insurance coverage providing benefits for: 15 (1) Hospital confinement indemnity; 16 (2) Disability income; 17 (3) Accident only; 18 (4) Long-term care; 19 (5) Medicare supplement; 20 (6) Limited benefit health; 21 (7) Specified disease indemnity; 22 (8) Sickness or bodily injury or death by accident or both; and 23 (9) Other limited benefit policies. 24 SECTION 3. Chapter 27-20 of the General Laws entitled Nonprofit Medical Service 25 Corporations is hereby amended by adding thereto the following section: 26 27-20-84. Licensed certified lactation counselor. 27 (a) As used in this section, “licensed certified lactation counselor” means a trained 28 professional who holds a licensure and certification by the department of health in accordance with 29 chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 30 evaluation, problem identification, treatment, education, and consultation to provide lactation care 31 and services to childbearing families, and infant children from birth to twelve (12) months old 32 within the scope of practice pursuant to the provisions of § 23-13.8-9. 33 (b) Every individual or group health insurance contract, or every individual or group 34 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, LC004236 - Page 3 of 6 1 or renewed in this state on or after January 1, 2027, shall provide coverage for the services of 2 lactation counselors in accordance with each health insurers respective principles and mechanisms 3 of reimbursement, credentialing, and contracting, if the services are within the lactation counselors 4 area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ( lactation 5 counselor practice act of 2024 ), and are currently reimbursed when rendered by any other health 6 care provider. No insurer or hospital or medical service corporation may require supervision, 7 signature, or referral by any other health care provider as a condition of reimbursement, except 8 when those requirements are also applicable to other categories of health care providers. No insurer 9 or hospital or medical service corporation or patient may be required to pay for duplicate services 10 actually rendered by both a licensed certified lactation counselor and any other health care provider. 11 (c) Every individual or group health insurance contract, or every individual or group 12 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 13 or renewed in this state that is required to cover licensed certified lactation counselor services 14 defined in subsection (a) of this section, shall report utilization and cost information related to 15 licensed certified lactation counselor services to the office of the health insurance commissioner on 16 or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner 17 shall define the utilization and cost information required to be reported. 18 (d) This section shall not apply to insurance coverage providing benefits for: 19 (1) Hospital confinement indemnity; 20 (2) Disability income; 21 (3) Accident only; 22 (4) Long-term care; 23 (5) Medicare supplement; 24 (6) Limited benefit health; 25 (7) Specified disease indemnity; 26 (8) Sickness or bodily injury or death by accident or both; and 27 (9) Other limited benefit policies. 28 SECTION 4. Chapter 27-41 of the General Laws entitled Health Maintenance 29 Organizations is hereby amended by adding thereto the following section: 30 27-41-101. Licensed certified lactation counselor. 31 (a) As used in this section, “licensed certified lactation counselor” means a trained 32 professional who holds a licensure and certification by the department of health in accordance with 33 chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, 34 evaluation, problem identification, treatment, education, and consultation to provide lactation care LC004236 - Page 4 of 6 1 and services to childbearing families, and infant children from birth to twelve (12) months old 2 within the scope of practice pursuant to the provisions of § 23-13.8-9. 3 (b) Every individual or group health insurance contract, or every individual or group 4 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 5 or renewed in this state on or after January 1, 2027, shall provide coverage for the services of 6 lactation counselors in accordance with each health insurers respective principles and mechanisms 7 of reimbursement, credentialing, and contracting, if the services are within the lactation counselors 8 area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ( lactation 9 counselor practice act of 2024 ), and are currently reimbursed when rendered by any other health 10 care provider. No insurer or hospital or medical service corporation may require supervision, 11 signature, or referral by any other health care provider as a condition of reimbursement, except 12 when those requirements are also applicable to other categories of health care providers. No insurer 13 or hospital or medical service corporation or patient may be required to pay for duplicate services 14 actually rendered by both a licensed certified lactation counselor and any other health care provider. 15 (c) Every individual or group health insurance contract, or every individual or group 16 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 17 or renewed in this state that is required to cover licensed certified lactation counselor services 18 defined in subsection (a) of this section, shall report utilization and cost information related to 19 licensed certified lactation counselor services to the office of the health insurance commissioner on 20 or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner 21 shall define the utilization and cost information required to be reported. 22 (d) This section shall not apply to insurance coverage providing benefits for: 23 (1) Hospital confinement indemnity; 24 (2) Disability income; 25 (3) Accident only; 26 (4) Long-term care; 27 (5) Medicare supplement; 28 (6) Limited benefit health; 29 (7) Specified disease indemnity; 30 (8) Sickness or bodily injury or death by accident or both; and 31 (9) Other limited benefit policies. 32 SECTION 5. This act shall take effect on January 1, 2027. ======== LC004236 ======== LC004236 - Page 5 of 6 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES *** 1 This act would require health insurance policies to cover licensed certified lactation 2 counselor services for childbearing families. It would also prohibit requiring supervision or 3 duplicate payments for services and mandates annual reporting. 4 This act would take effect on January 1, 2027. ======== LC004236 ======== LC004236 - Page 6 of 6