Authorizes a physician practice to charge a practice support contribution; provided that, the amount does not exceed $120 per year, per patient, enrolled in a healthcare insurance plan, (excluding Medicaid and traditional Medicare).
Summary
H6353 creates the “Primary Care Preservation Act” and authorizes Rhode Island physician practices to charge patients a new annual “practice support contribution” of up to $120 per patient for operational services tied to outpatient primary care. The bill defines the charge as covering support functions such as reception, referral coordination, medication refill management, medical assistant support, and general overhead. The amount would be indexed annually to the consumer price index, and the charge would apply to patients enrolled in health insurance plans, but not to Medicaid or traditional Medicare beneficiaries.
The bill also limits interference by insurers and other payors. It prohibits payor contracts from barring a physician practice from billing patients directly for the contribution, and it bars payors from collecting the fee on the practice’s behalf. In addition, physician practices could require payment of the contribution before scheduling non-emergent appointments for patients in insurance plans or Medicare Advantage, while still being required to provide standard care to patients who are behind on payment, including 30 days of medication refills and medical record transfers. The act would take effect immediately upon passage.
Impact
If enacted, the bill would add a new chapter to Title 5 of the Rhode Island General Laws governing business and professions and would expressly authorize a new patient-facing fee structure for physician practices. It would affect contracts between payors and physician practices by limiting non-interference clauses, and it would change how practices may condition access to non-emergency care for insured and Medicare Advantage patients. The bill would not apply to Medicaid or traditional Medicare patients, and it leaves room for reimbursement by the state or payors if processed separately from direct patient billing.
Sentiment
Based on the bill text and the absence of recorded committee testimony or votes, the available record shows no formalized public sentiment in the materials provided. The bill’s framing suggests support for primary care practices by creating an additional revenue stream to help cover operating costs, which may appeal to physician groups and supporters of practice sustainability. At the same time, the proposal’s patient fee and scheduling conditions could draw concern from consumer advocates, insurers, and patient access stakeholders.
Contention
The main points of contention are likely to be the new annual charge itself, the ability of practices to require payment before non-emergent appointments, and the restriction on insurer contract terms. Supporters may view the fee as a necessary tool to preserve primary care operations and continuity, while opponents may argue it adds out-of-pocket costs, could create barriers to access, and shifts costs onto patients with commercial coverage and Medicare Advantage. The exclusion of Medicaid and traditional Medicare patients may also raise questions about fairness and administrative complexity.