The bill amends Section 42-14.5-3 of the Rhode Island General Laws, expanding the duties of the health insurance commissioner. New responsibilities include holding quarterly public meetings, making recommendations to the governor and finance committees, preparing draft legislation, and establishing an advisory council to develop proposals for affordable small business health insurance. 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 text provided, but the bill does mention the removal of language related to the uniform processing of claim corrections.

Additionally, the bill focuses on streamlining healthcare administration and improving the prior authorization process. It requires the establishment of a workgroup to develop guidelines and standards for healthcare administration, with recommendations to be submitted to the Rhode Island house and senate health and human services committees. The bill also mandates updates to prior authorization lists, transparency in prior authorization requirements, and protections for patient care continuity. It includes insertions clarifying coverage for behavioral health care and outlines the commissioner's responsibilities in monitoring health plan compliance with the Mental Health Parity Act. The bill requires various reports to be submitted to the general assembly on topics such as anti-cancer medication and compliance with mental health provisions. Lastly, it 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 departments to include these assessments in their annual budget submissions.

Statutes affected:
290  SUB A as amended: 42-14.5-3
290  SUB A: 42-14.5-3
290: 42-14.5-3