The bill amends Section 42-14.5-3 of the Rhode Island General Laws to expand the responsibilities of the health insurance commissioner. New provisions require the commissioner to conduct quarterly public meetings to discuss health insurers' rates, services, and operations, and their effects on stakeholders. The commissioner will also make recommendations to the governor and finance committees regarding healthcare regulations, establish an advisory council to propose affordable small business health insurance solutions, and prepare annual reports with findings and recommendations. The advisory council will develop a complaint process for small businesses facing rate increases and assess the health provider community's views on insurance reimbursement rates.

Additionally, the bill mandates a comprehensive analysis of the health insurance market, focusing on the potential merger of small-group and individual markets, and establishes a workgroup to streamline healthcare administration processes. It emphasizes the need for transparency in the prior authorization process for medical services and prescription drugs, requiring health plans to communicate changes effectively. The bill also introduces measures for analyzing reimbursement and financing for primary care services, with the health insurance commissioner tasked with publishing reports on these topics every two years. A nine-member advisory committee will assist the commissioner, ensuring diverse representation from various healthcare stakeholders. The act will take effect upon passage, enhancing oversight and strategic planning for primary care services in Rhode Island.

Statutes affected:
6119: 42-14.5-3