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. Licensed certified lactation counselor.
(a) As used in this section, “licensed certified lactation counselor” means a trained professional who holds a licensure and certification by the department of health in accordance with chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, evaluation, problem identification, treatment, education, and consultation to provide lactation care and services to childbearing families, and infant children from birth to twelve (12) months old within the scope of practice pursuant to the provisions of § 23-13.8-9.
(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 lactation counselors in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation counselor practice act of 2024"), and are currently reimbursed when rendered by any other health care provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other health care provider as a condition of reimbursement, except when those requirements are also applicable to other categories of health care providers. No insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a licensed certified lactation counselor and any other health care 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 licensed certified lactation counselor services defined in subsection (a) of this section, shall report utilization and cost information related to licensed certified lactation counselor 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.
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. Licensed certified lactation counselor.
(a) As used in this section, “licensed certified lactation counselor” means a trained professional who holds a licensure and certification by the department of health in accordance with chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, evaluation, problem identification, treatment, education, and consultation to provide lactation care and services to childbearing families, and infant children from birth to twelve (12) months old within the scope of practice pursuant to the provisions of § 23-13.8-9.
(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 lactation counselors in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation counselor practice act of 2024"), and are currently reimbursed when rendered by any other health care provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other health care provider as a condition of reimbursement, except when those requirements are also applicable to other categories of health care providers. No insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a licensed certified lactation counselor and any other health care 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 licensed certified lactation counselor services defined in subsection (a) of this section, shall report utilization and cost information related to licensed certified lactation counselor 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.
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. Licensed certified lactation counselor.
(a) As used in this section, “licensed certified lactation counselor” means a trained professional who holds a licensure and certification by the department of health in accordance with chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, evaluation, problem identification, treatment, education, and consultation to provide lactation care and services to childbearing families, and infant children from birth to twelve (12) months old within the scope of practice pursuant to the provisions of § 23-13.8-9.
(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 lactation counselors in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation counselor practice act of 2024"), and are currently reimbursed when rendered by any other health care provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other health care provider as a condition of reimbursement, except when those requirements are also applicable to other categories of health care providers. No insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a licensed certified lactation counselor and any other health care 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 licensed certified lactation counselor services defined in subsection (a) of this section, shall report utilization and cost information related to licensed certified lactation counselor 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.
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. Licensed certified lactation counselor.
(a) As used in this section, “licensed certified lactation counselor” means a trained professional who holds a licensure and certification by the department of health in accordance with chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment, evaluation, problem identification, treatment, education, and consultation to provide lactation care and services to childbearing families, and infant children from birth to twelve (12) months old within the scope of practice pursuant to the provisions of § 23-13.8-9.
(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 lactation counselors in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the lactation counselors' area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation counselor practice act of 2024"), and are currently reimbursed when rendered by any other health care provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other health care provider as a condition of reimbursement, except when those requirements are also applicable to other categories of health care providers. No insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a licensed certified lactation counselor and any other health care 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 licensed certified lactation counselor services defined in subsection (a) of this section, shall report utilization and cost information related to licensed certified lactation counselor 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.
SECTION 5. This act shall take effect on January 1, 2027.
