The bill amends the Rhode Island Health Care Reform Act of 2004 to update definitions and expand the powers and duties of the health insurance commissioner. New definitions include "primary care services," "accountability standards," "Executive Office of Health and Human Services (EOHHS)," "rate review," "rate setting," "social and human service program," "social and human service provider," and "state government and the provider network." The health insurance commissioner is given new responsibilities, such as holding quarterly public meetings, making recommendations on health insurance regulation, and establishing a consumer/business/labor/medical advisory council. This council will address health insurance concerns, develop a complaint process for small businesses, and issue an annual report. A subcommittee will provide annual reports to the finance committees and develop a method for health plans to disclose fee schedules to providers.

The bill also includes provisions to improve healthcare administration and insurance processes, such as standardizing provider applications, using uniform claim forms, and making facility-specific data on quality and costs available to patients. It addresses contractual disclosure, insurance enrollment status confirmation, provider credentialing, contract renegotiations, and the impact of silent PPOs. The bill requires enforcement of provisions in titles 27 and 42, analysis of the Rhode Island affordable health plan reinsurance fund, and consideration of reinsurance mechanisms. A task force will assist with the analysis, and a workgroup will develop processes to streamline healthcare administration, with recommendations due by June 30, 2024. The bill also aims to improve billing and authorization processes, ensure transparency, and promote continuity of care, including the use of electronic prior authorization technology and annual reporting on hospital payment variation. Additionally, the bill requires the inclusion of primary care services in biennial reports starting from September 1, 2025, and outlines the responsibilities of state departments in the assessment process. The act will take effect upon passage.