Rhode Island § 27-18.9-16 § 27-18.9-16. Prior authorization reduction and improvement. [Expires October 1, 2028]

Rhode Island Statutes

§ 27-18.9-16 — § 27-18.9-16. Prior authorization reduction and improvement. [Expires October 1, 2028]

Rhode Island § 27-18.9-16

Title 27Insurance

Ch. 27-18.9Benefit Determination and Utilization Review Act

This text of Rhode Island § 27-18.9-16 (§ 27-18.9-16. Prior authorization reduction and improvement. [Expires October 1, 2028]) is published on Counsel Stack Legal Research, covering Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

R.I. Gen. Laws § 27-18.9-16 (2026).

Text

§ 27-18.9-16. Prior authorization reduction and improvement. [Expires October 1, 2028]
(a) The purpose of this chapter is to authorize a three-year (3) pilot program whereby,
            except as provided in subsection (b), an insurer shall not impose a prior authorization
            requirement for any admission, item, service, treatment, or procedure ordered by a
            primary care provider in the normal course of providing primary care treatment.
         
(b) The prohibition set forth in subsection (a) shall not be construed to prohibit prior
            authorization requirements for prescription drugs.
         
(c) Nothing 

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§ 27-18.9-16. Prior authorization reduction and improvement. [Expires October 1, 2028]

(a) The purpose of this chapter is to authorize a three-year (3) pilot program whereby, except as provided in subsection (b), an insurer shall not impose a prior authorization requirement for any admission, item, service, treatment, or procedure ordered by a primary care provider in the normal course of providing primary care treatment.

(b) The prohibition set forth in subsection (a) shall not be construed to prohibit prior authorization requirements for prescription drugs.

(c) Nothing in this section shall be construed to modify the rights or obligations of an insurer or provider with respect to procedures relating to the investigation, audit, reporting, or appeal, under applicable law of potentially fraudulent billing activities, waste or abuse.

(d) Annually on or before July 1, each insurer shall submit to the office of the governor, the speaker of the house of representatives, the president of the senate, and the office of the health insurance commissioner a written report in compliance with the rules and regulations to be promulgated by the office of the health insurance commissioner on or before January 1, 2026.

(e) Unless an act of the general assembly expressly authorizes the continuation of the program, the provisions of this chapter shall sunset and expire on October 1, 2028.