HEALTH AND SAFETY -- DEPARTMENT OF HEALTH, the official text

H7625 2026 -- H 7625 ======== LC004819 ======== STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2026 ____________ A N A C T RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH Introduced By: Representatives Donovan, Speakman, Boylan, Spears, Tanzi, Kislak, Giraldo, Stewart, Fogarty, and Carson Date Introduced: February 11, 2026 Referred To: House Health & Human Services (Dept. of Health) It is enacted by the General Assembly as follows: 1 SECTION 1. Section 23-1-44 of the General Laws in Chapter 23-1 entitled Department 2 of Health is hereby amended to read as follows: 3 23-1-44. Routine childhood and adult immunization vaccines. 4 (a) The department of health shall include in the department’s immunization program those 5 vaccines for routine childhood immunization as recommended by the Advisory Committee for 6 Immunization Practices (ACIP) and the Academy of Pediatrics (AAP) or as determined by the 7 director of the department of health to be necessary to protect the public health , and for routine 8 adult immunization as recommended by the ACIP, or as determined by the director of the 9 department of health to be necessary to protect the public health to the extent permitted by available 10 funds . The immunization program includes administrative and quality assurance services and the 11 Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized 12 information system that is used to manage statewide immunizations, for all persons in Rhode 13 Island. 14 (b) The director of the department of health shall appoint an advisory committee that will 15 be convened after the ACIP makes a recommendation regarding immunization at the discretion of 16 the director . The committee will review the ACIP recommendations for the state and director- 17 initiated proposals for the state ; assess the vaccine cost and feasibility; and advise the director of 18 health and the office of the health insurance commissioner regarding insurers and providers acting 19 on the ACIP immunization recommendation immunization recommendations or proposals . All 1 recommendations will be posted on the department of health website. The advisory committee 2 membership shall include, but not be limited to, a primary care provider, an epidemiologist, a 3 pharmacist, major insurers, and at the discretion of the director, representatives of the nursing home 4 industry , and the home healthcare industry and major insurers . 5 (c) For the purpose of protecting patients’ information, all personally-identifiable 6 information obtained pursuant to this section shall be subject to the privacy protections of chapter 7 37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 8 104-191 (HIPAA), as amended. 9 SECTION 2. Chapter 27-18 of the General Laws entitled Accident and Sickness Insurance 10 Policies is hereby amended by adding thereto the following section: 11 27-18-96. Coverage for vaccinations. 12 Every individual or group medical service contract or every individual or group hospital or 13 medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state 14 on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations 15 recommended by the Rhode Island department of health (RIDOH). 16 SECTION 3. Chapter 27-19 of the General Laws entitled Nonprofit Hospital Service 17 Corporations is hereby amended by adding thereto the following section: 18 27-19-88. Coverage for vaccinations. 19 Every individual or group medical service contract or every individual or group hospital or 20 medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state 21 on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations 22 recommended by the Rhode Island department of health (RIDOH). 23 SECTION 4. Chapter 27-20 of the General Laws entitled Nonprofit Medical Service 24 Corporations is hereby amended by adding thereto the following section: 25 27-20-84. Coverage for vaccinations. 26 Every individual or group medical service contract or every individual or group hospital or 27 medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state 28 on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations 29 recommended by the Rhode Island department of health (RIDOH). 30 SECTION 5. Chapter 27-41 of the General Laws entitled Health Maintenance 31 Organizations is hereby amended by adding thereto the following section: 32 27-41-101. Coverage for vaccinations. 33 Every individual or group medical service contract or every individual or group hospital or 34 medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state LC004819 - Page 2 of 5 1 on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations 2 recommended by the Rhode Island department of health (RIDOH). 3 SECTION 6. Chapter 40-8 of the General Laws entitled Medical Assistance is hereby 4 amended by adding thereto the following section: 5 40-8-33. Coverage for vaccinations. 6 Commencing January 1, 2027, the medical assistance program shall provide coverage, 7 without cost-sharing, for all vaccinations recommended by the Rhode Island department of health 8 (RIDOH). This recommendation shall apply to all Medicaid beneficiaries, whether enrolled in fee- 9 for-service or managed care, to the extent permitted under federal law. 10 SECTION 7. Chapter 40-8.5 of the General Laws entitled Health Care for Elderly and 11 Disabled Residents Act is hereby amended by adding thereto the following section: 12 40-8.5-1.2. Coverage for vaccinations. 13 (a) As used herein, managed care systems is defined as systems that: integrate an efficient 14 financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate 15 care and deter unnecessary services; and place emphasis on preventive and primary care. For 16 purposes of this section, managed care systems may also be defined to include a primary care case- 17 management model, community health teams, and/or other such arrangements that meet standards 18 established by the executive office and serve the purposes of this section. Managed care systems 19 may also include services and supports that optimize the health and independence of beneficiaries 20 who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title (“long- 21 term care service reform for Medicaid eligible individuals”) or to be at risk for the care under the 22 applicable federal state plan or waiver authorities and the rules and regulations promulgated by the 23 executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance 24 may be provided such services through an entity certified by, or in a contractual arrangement with, 25 the executive office or, as deemed appropriate, exempt from mandatory managed care in 26 accordance with rules and regulations promulgated by the executive office. 27 (b) Commencing January 1, 2027, any Medicaid managed care organizations under 28 contract with the executive office of health and human services shall provide coverage, without 29 cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH), 30 to the extent permitted under federal law. 31 SECTION 8. Chapter 36-12 of the General Laws entitled Insurance Benefits is hereby 32 amended by adding thereto the following section: 33 36-12-2.1.1. Coverage for vaccinations. 34 Commencing January 1, 2027, the director of administration shall administer health benefit LC004819 - Page 3 of 5 1 programs for state employees and retirees, and shall ensure that coverage is provided, without cost- 2 sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH). 3 SECTION 9. Severability. 4 If any section of this act or its application to any person or circumstance is held invalid, the 5 invalidity shall not affect other sections or applications of the act that can be given effect without 6 the invalid section or application, and to this end the sections of this act are declared severable. 7 SECTION 10. This act shall take effect upon passage. ======== LC004819 ======== LC004819 - Page 4 of 5 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH *** 1 Commencing January 1, 2027, this act would mandate insurers provide health insurance 2 coverage without cost-share requirements for vaccinations recommended by the state department 3 of health and would mandate the coverage for the medical assistance program and managed care 4 organizations. 5 This act would take effect upon passage. ======== LC004819 ======== LC004819 - Page 5 of 5