The bill amends Section 42-14.5-3 of the Rhode Island General Laws to expand the duties of the health insurance commissioner. New insertions include the commissioner's responsibility to hold quarterly public meetings, make recommendations to the governor and finance committees, prepare draft legislation, and establish advisory councils and subcommittees to address issues such as affordable small business health insurance and insurance complaint processes. The commissioner is also tasked with analyzing the Rhode Island affordable health plan reinsurance fund and the potential impact of merging individual and small-employer health insurance markets. Specific deletions from the current law are not detailed in the provided text.

Additionally, the bill sets forth provisions for streamlining healthcare administration through a workgroup that will make recommendations on standards and guidelines for processes like electronic eligibility verification and fraud detection. The health insurance commissioner must submit these recommendations to the Rhode Island house and senate health and human services committees and provide a report to the general assembly by June 30, 2024. The bill also addresses the management of prior authorization for medical services and prescription drugs, requiring annual reviews, transparency, and continuity of patient care. It encourages the use of electronic prior authorization technology and specifies that these provisions should not interfere with the office of health insurance commissioner’s administrative simplification task force. Lastly, the bill mandates the hiring of staff and contracting with a firm to analyze social and human service programs, with findings to be reported to government officials and included in annual budget submissions.

Statutes affected:
5495  SUB A: 42-14.5-3
5495: 42-14.5-3