RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Summary
H7275 would require most Rhode Island health insurance contracts and policies issued or renewed on or after January 1, 2027 to cover services provided by licensed certified professional midwives (CPMs). The bill defines a CPM as a midwife who has completed an accredited midwifery program, holds current NARM certification, and is licensed under state law. Coverage would apply only when the services are within the CPM’s professional competence, as defined by a MANA standard developed in collaboration with the Department of Health, and only for services that are already reimbursed when provided by another healthcare provider.
The bill also bars insurers, hospital service corporations, and medical service corporations from requiring supervision, a signature, or a referral from another provider as a condition of reimbursement, unless the same requirement applies to other provider categories. It further prohibits payment for duplicate services when both a CPM and another provider render the same service. In addition, affected insurers must report utilization and cost information related to CPM services to the Office of the Health Insurance Commissioner beginning July 1, 2027 and annually thereafter.
Impact
The bill would add new coverage mandates to Rhode Island’s insurance code by creating parallel provisions in the chapters governing accident and sickness insurance policies, nonprofit hospital service corporations, nonprofit medical service corporations, and health maintenance organizations. It would effectively override conflicting state laws or regulations, including specified provisions in the midwifery licensing and insurance statutes, to the extent they are inconsistent with the new coverage requirement. The mandate would not apply to several limited-benefit products, including accident-only, disability income, long-term care, Medicare supplement, and other specified limited coverage policies.
Sentiment
Based on the bill text and the absence of recorded committee testimony or votes, the measure appears to be framed as a pro-access insurance mandate for midwifery care rather than a controversial restructuring of coverage. The sponsor list suggests support from multiple House members, and the bill’s explanation presents it as a straightforward coverage expansion with reporting requirements and a delayed effective date. No formal vote history or transcript record is provided, so there is no documented opposition or support beyond the bill’s structure and caption.
Contention
The main points of potential contention are likely to be the insurance mandate itself, the use of external professional standards to define covered CPM services, and the preemption of conflicting state laws and regulations. Insurers may object to being required to cover a provider type they do not currently reimburse in all circumstances, while supporters would likely emphasize access to maternity and birthing care and parity with other reimbursable providers. The bill also limits coverage to services already reimbursed for other providers and excludes duplicate billing, which appears designed to address cost concerns and may be a focal point in any debate over utilization and reimbursement rules.
Requires health insurance plans to cover services provided by licensed certified professional midwives. Insurers must report utilization and cost data annually. Certain limited benefit policies are exempt.
Requires health insurance policies to cover licensed certified lactation counselor services for childbearing families. It also prohibits requiring supervision or duplicate payments for services and mandates annual reporting.
Requires health insurance policies to cover licensed certified lactation counselor services for childbearing families. It also prohibits requiring supervision or duplicate payments for services and mandates annual reporting.
Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of diagnosing and treating infertility, for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with IVF.
Requires individual and group health insurance policies that provide pregnancy-related benefits to cover medically necessary expenses for diagnosis and treatment of infertility and standard fertility-preservation services.
AN ACT to amend Tennessee Code Annotated, Title 8; Title 33; Title 36; Title 49; Title 52; Title 56; Title 63 and Title 68, relative to professional counselors.
AN ACT to amend Tennessee Code Annotated, Title 8; Title 33; Title 36; Title 49; Title 52; Title 56; Title 63 and Title 68, relative to professional counselors.
Occupations: individual licensing and registration; licensure of professional guardians and conservators; require. Amends sec. 303a of 1980 PA 299 (MCL 339.303a) & adds art. 14A.