RI 2026 H7275: Insurance - Accident and Sickness Insurance Policies

Plain-English Summary

This legislation mandates that health insurance companies in Rhode Island provide coverage for services rendered by Certified Professional Midwives (CPMs), starting January 1, 2027. The bill specifies that CPMs must be properly trained, certified by the North American Registry of Midwives, and licensed by the state. Insurance plans cannot require a midwife to be supervised by another healthcare provider for reimbursement unless that rule applies to all providers. Additionally, insurers must report data regarding the cost and usage of midwifery services to the Office of the Health Insurance Commissioner annually.

For younger readers

This new rule helps families who want to use a midwife when having a baby. A midwife is a trained person who helps mothers give birth. Before this rule, health insurance might not have paid for a midwife, so families had to pay all the money themselves. This bill says that insurance companies must pay for the midwife's help, just like they pay for a doctor. This makes it easier for families to choose how they want to have their baby. The rule starts in the year 2027.

Who & Where It Applies

Impacted groups

Certified Professional MidwivesPregnant womenHealth insurance companiesHospital administratorsOffice of the Health Insurance Commissioner

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

None

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Expands reproductive healthcare choices and bodily autonomy by making midwifery care financially accessible to more families, rather than restricting birth options to clinical hospital settings.
Promotes economic equity by ensuring that insurance covers midwifery services, reducing out-of-pocket costs for low-to-middle-income families who prefer this model of care.
Validates and supports a profession historically dominated by women, integrating their services into the mainstream healthcare system and ensuring they are paid fairly by insurers.
Relies on the private health insurance industry to deliver access, rather than establishing a universal public system that guarantees care regardless of employment or policy status.
The delay in implementation until 2027 leaves families currently seeking midwifery care without financial support for several more years.
May not go far enough to address broader systemic disparities in maternal mortality rates among marginalized communities if the number of available licensed midwives remains low.

For Conservatives

Encourages market competition in healthcare by empowering alternative providers, potentially breaking the monopoly held by large hospital systems and doctors' groups.
Supports individual liberty and parental rights by allowing families to choose the type of birth experience they prefer without financial penalization.
Could potentially lower overall healthcare spending, as midwifery care is often less expensive than high-intervention hospital births and cesarean sections.
Imposes heavy-handed government mandates on private businesses by forcing insurance companies to cover specific services, interfering with the free market and contract rights.
Creates new bureaucracy and compliance costs by requiring insurers to report detailed utilization and cost data to a government commissioner.
Overrides existing contracts and potentially local rules through a supremacy clause, disregarding the sanctity of private agreements and decentralized governance.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 167 additions

SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section: 27-18-96. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited to, §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section: 27-19-88. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section: 27-20-84. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section: 27-41-101. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

SECTION 5. This act shall take effect on January 1, 2027.