The bill amends Chapters 27-18 and 27-19 of the General Laws to include provisions for community health workers (CHWs) in health insurance coverage. It defines a CHW as a trained professional who provides medically necessary services for patients with chronic health conditions or those at risk, including health coaching, education, system navigation, care planning, and follow-up care. Starting January 1, 2026, all individual or group health insurance contracts and medical expense policies issued or renewed in the state must cover services provided by CHWs, as long as these services fall within the CHW's professional competence as defined by the Rhode Island certification board.

The bill also prohibits insurers from imposing supervision or referral requirements for CHWs that are not applicable to other healthcare providers and ensures that patients or insurers are not charged for duplicate services rendered by both a CHW and another provider. Insurers are required to report utilization and cost information related to CHW services to the health insurance commissioner by July 1, 2027, and annually thereafter. However, the provisions do not apply to certain types of insurance coverage, including hospital confinement indemnity, disability income, accident-only policies, long-term care, and other limited benefit policies. The act is set to take effect on January 1, 2026.