Shown verbatim: the complete text as captured from the official PDF posted by the Rhode Island General Assembly, fetched 2026-07-29. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
H8367 2026 -- H 8367 ======== LC006194 ======== 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 Donovan, Kislak, Fogarty, Boylan, Potter, Giraldo, Furtado, Tanzi, Shallcross Smith, and Ajello Date Introduced: March 27, 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. Post-acute care prior authorization. 4 (a) As used in this section: 5 (1) “Post-acute care services” means specialized behavioral, medical, rehabilitative, or 6 homecare services provided to a patient discharged from an acute care hospital to improve the 7 patient’s functional independence and manage the patient’s ongoing health conditions. 8 (b) Every individual or group health insurance contract, or every individual or group 9 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 10 or renewed in this state on or after January 1, 2027 shall provide coverage for post-acute care 11 services, as defined in subsection (a) of this section, for a minimum of seven (7) days and shall not 12 be subject to preauthorization prior to obtaining post-acute care services; provided, the discharging 13 hospital shall provide the insurer with notification prior to discharge and admission to post-acute 14 care; provided further, the utilization review procedures may be initiated on day seven (7). Medical 15 necessity shall be determined by the treating healthcare provider and shall be noted in the patient’s 16 medical record and discharge plan. 17 SECTION 2. Chapter 27-19 of the General Laws entitled Nonprofit Hospital Service 18 Corporations is hereby amended by adding thereto the following section: 19 27-19-88. Post-acute care prior authorization. 1 (a) As used in this section: 2 (1) “Post-acute care services” means specialized behavioral, medical, rehabilitative, or 3 homecare services provided to a patient discharged from an acute care hospital to improve the 4 patient’s functional independence and manage the patient’s ongoing health conditions. 5 (b) Every individual or group health insurance contract, or every individual or group 6 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 7 or renewed in this state on or after January 1, 2027 shall provide coverage for post-acute care 8 services, as defined in subsection (a) of this section, for a minimum of seven (7) days and shall not 9 be subject to preauthorization prior to obtaining post-acute care services; provided, the discharging 10 hospital shall provide the insurer with notification prior to discharge and admission to post-acute 11 care; provided further, the utilization review procedures may be initiated on day seven (7). Medical 12 necessity shall be determined by the treating healthcare provider and shall be noted in the patient’s 13 medical record and discharge plan. 14 SECTION 3. Chapter 27-20 of the General Laws entitled Nonprofit Medical Service 15 Corporations is hereby amended by adding thereto the following section: 16 27-20-84. Post-acute care prior authorization. 17 (a) As used in this section: 18 (1) “Post-acute care services” means specialized behavioral, medical, rehabilitative, or 19 homecare services provided to a patient discharged from an acute care hospital to improve the 20 patient’s functional independence and manage the patient’s ongoing health conditions. 21 (b) Every individual or group health insurance contract, or every individual or group 22 hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, 23 or renewed in this state on or after January 1, 2027 shall provide coverage for post-acute care 24 services, as defined in subsection (a) of this section, for a minimum of seven (7) days and shall not 25 be subject to preauthorization prior to obtaining post-acute care services; provided, the discharging 26 hospital shall provide the insurer with notification prior to discharge and admission to post-acute 27 care; provided further, the utilization review procedures may be initiated on day seven (7). Medical 28 necessity shall be determined by the treating healthcare provider and shall be noted in the patient’s 29 medical record and discharge plan. 30 SECTION 4. 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. Post-acute care prior authorization. 33 (a) As used in this section: 34 (1) “Post-acute care services” means specialized behavioral, medical, rehabilitative, or LC006194 - Page 2 of 4 1 homecare services provided to a patient discharged from an acute care hospital to improve the 2 patient’s functional independence and manage the patient’s ongoing health conditions. 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 post-acute care 6 services, as defined in subsection (a) of this section, for a minimum of seven (7) days and shall not 7 be subject to preauthorization prior to obtaining post-acute care services; provided, the discharging 8 hospital shall provide the insurer with notification prior to discharge and admission to post-acute 9 care; provided further, the utilization review procedures may be initiated on day seven (7). Medical 10 necessity shall be determined by the treating healthcare provider and shall be noted in the patient’s 11 medical record and discharge plan. 12 SECTION 5. This act shall take effect upon passage. ======== LC006194 ======== LC006194 - Page 3 of 4 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES *** 1 This act would require healthcare insurers, without prior authorization, to provide post- 2 acute care services to patients discharged from a hospital for a minimum of seven (7) days 3 commencing on or after January 1, 2027. 4 This act would take effect upon passage. ======== LC006194 ======== LC006194 - Page 4 of 4
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