The bill amends Section 42-14.5-3 of the Rhode Island Health Care Reform Act of 2004, expanding the powers and responsibilities of the Office of the Health Insurance Commissioner (OHIC). It mandates the OHIC to undertake analyses, reports, studies, and recommendations regarding reimbursement and financing for the provision of primary care services to Rhode Island patients. The analyses will examine all sources of financing for primary care, including Medicaid, commercial insurance, and Medicare, and will consider various payment methodologies such as shared savings programs and capitation.

The OHIC is required to publish and submit biennial reports to the General Assembly, outlining current financing structures and reimbursement rates for primary care providers, as well as making and justifying recommendations for adjustments to primary care reimbursement and financing. The first report is due on or before July 1, 2026, with subsequent reports every two years thereafter. The OHIC may delay the first report's completion by up to ninety days if notice is provided to the General Assembly.

Additionally, the bill establishes a nine-member advisory committee to advise the OHIC, with members selected by the governor, including representatives from large and small primary care providers, hospitals, community health centers, Medicaid Managed Care Organizations, and patient care advocacy groups. The proceedings of this advisory committee will be subject to open meetings laws.

The act is set to take effect immediately upon passage, facilitating prompt implementation of these reforms to enhance healthcare oversight in Rhode Island.

Statutes affected:
6119: 42-14.5-3