The bill amends Section 42-14.5-3 of the Rhode Island Health Care Reform Act of 2004, enhancing the powers and duties of the Office of the Health Insurance Commissioner (OHIC). It requires that population-based contracts include a provision for a budget agreement for each contract year, with prior approval from OHIC required if any annual increase in the total cost of care for services reimbursed under the contract, after risk adjustment, exceeds the Consumer Price Index for all Urban Consumers (CPI-U) percentage increase, plus three and one-half percent (3.5%) for the period from October 1, 2025, to September 30, 2028.

Additionally, hospital contracts must include a provision for agreed rates for each contract year, with prior approval from OHIC required if the average rate increase, including estimated quality incentive payments, is greater than the CPI-U percentage increase, plus three percent (3%) for the same period.

The act aims to enhance oversight capabilities of OHIC, ensuring compliance with established regulations and promoting transparency and accountability in the healthcare system. The provisions of the act will take effect upon passage.

Statutes affected:
5832: 42-14.5-3