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, reported by the commissioner by October 1 of each year. This percentage increase shall be plus three and one-half percent (3.5%) beginning October 1, 2025, and ending on September 30, 2028.

Additionally, the bill mandates that hospital contracts 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, also reported by the commissioner by October 1 each year. This percentage increase shall be plus three percent (3%) beginning October 1, 2025, and ending on September 30, 2028.

The act aims to promote transparency, accountability, and affordability in the healthcare system, with provisions taking effect upon passage.

Statutes affected:
681: 42-14.5-3