Skip to main content
H 7427Licensing & Accreditation

Businesses and Professions - The Primary Care Preservation Act

This bill allows doctors to charge patients extra fees for administrative tasks and bans insurers from stopping them.

On the floor65 Yea8 Nay2 Not voting
Population
Affected
65
Email Legislator
Introduced Jan 30, 2026Committee House Health & Human Services

Plain-English Summary

This legislation, titled "The Primary Care Preservation Act," authorizes medical practices to charge patients directly for administrative and operational costs. These costs include services such as scheduling, care coordination, and record handling. The bill explicitly prohibits health insurance companies (payors) from including clauses in their contracts that restrict or penalize doctors for charging these fees. Physicians must disclose these fees to patients in advance. While insurers are not required to reimburse these fees, they cannot void contracts because of them. Emergency care must still be provided regardless of fee payment.

For younger readers

This new rule helps doctors' offices. Sometimes, doctors want to charge extra money for the work their office staff does, like answering phones, making appointments, and organizing paperwork. Right now, insurance companies often tell doctors they are not allowed to charge patients extra for this. This bill says that insurance companies cannot stop doctors from charging this extra fee anymore. The doctor must tell you about the fee before they charge you. However, if you have a big emergency, the doctor still has to help you even if you haven't paid this fee.

Who & Where It Applies

Impacted groups
PatientsPhysiciansHealth Insurance CompaniesMedical Office StaffLow-income Residents
Impacted communities
All

Constitutional & Fiscal Check

Moderate risk

Low to Moderate. The bill restricts the ability of private entities to freely contract by declaring specific terms void. This could be challenged under the Contracts Clause. However, states possess broad police powers to regulate the insurance industry and healthcare standards for the public welfare. Courts generally defer to state economic regulations unless they constitute a severe impairment of contract without a significant public purpose.

Estimated cost
None
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Strengthens the financial viability of independent primary care practices, potentially preventing them from being bought out by large corporate hospital systems.
  • Reduces the leverage and control that large, for-profit insurance corporations hold over healthcare providers and their business operations.
  • Mandates that emergency and urgent care cannot be denied based on the non-payment of these administrative fees, preserving a baseline of safety.
  • Increases out-of-pocket healthcare costs for patients by allowing "junk fees" for standard administrative tasks that should be covered by insurance.
  • Disproportionately harms low-income individuals who may avoid seeking necessary preventative care due to the inability to pay these additional upfront fees.
  • Creates a two-tiered healthcare system where access to efficient scheduling and coordination is privileged to those who can afford the extra charges.
For Conservatives
  • Promotes free-market principles by allowing private businesses (physician practices) to determine their own pricing models for administrative services.
  • Reduces the regulatory stranglehold that insurance companies have over the day-to-day operations of private medical practices.
  • Encourages the sustainability of small business owners in the medical field by opening new revenue streams independent of third-party reimbursement.
  • Represents government interference in the right of private entities (insurers and doctors) to freely negotiate the terms of their own contracts.
  • Sets a precedent for the state to declare specific voluntary contract terms "null and void," undermining the sanctity of contract law.
  • May inhibit the ability of the market to naturally control healthcare costs, potentially leading to higher overall spending.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 37 additions

SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" is hereby amended by adding thereto the following chapter: 5-37.9-1. Short title. This chapter shall be known and may be cited as "The Primary Care Preservation Act." 5-37.9-2. Definitions. As used in this chapter, the following words and terms shall have the meanings ascribed to them below unless the context clearly indicates otherwise:

(1) "Administrative or operational fee" means a reasonable charge assessed by a physician practice to patients for non-clinical services necessary to support operations including, but not limited to, reception, scheduling, care coordination, referral management, communication systems, record handling, and other administrative functions.

(2) "Payor" means any insurer, health maintenance organization, or other entity responsible for payment of healthcare services under a health plan.

(3) "Physician practice" means a medical practice owned or operated by one or more licensed physicians providing outpatient care in the State of Rhode Island. 5-37.9-3. Payor contract restrictions prohibited.

(a) No payor shall include in any contract, agreement, or participation document with a physician practice any clause or provision that prohibits, restricts, penalizes, or interferes with the ability of the practice to charge, bill, or collect a reasonable administrative or operational fee directly from patients.

(b) No payor shall impose conditions, penalties, or sanctions on a physician practice for assessing such fees, provided that the fees are disclosed to patients in advance and are not billed to the payor.

(c) Nothing in this section shall be construed to require a payor to reimburse a physician practice or patient for such fees. 5-37.9-4. Patient access and continuity of care.

(a) Nothing in this chapter shall limit a physician practice’s obligation to provide emergency or urgent care regardless of payment of any administrative or operational fee.

(b) Physician practices shall provide reasonable notice and access to patient medical records consistent with state and federal law. 5-37.9-5. Enforcement. Any provision in a payor contract that violates this chapter shall be deemed null and void and unenforceable as a matter of public policy. 5-37.9-6. Severability. If any clause, sentence, paragraph, section, or part of this chapter shall be adjudged by any court of competent jurisdiction to be invalid, that judgment shall not affect, impair, or invalidate the remainder of the chapter but shall be confined in its operation to the clause, sentence, paragraph, section, or part directly involved in the controversy in which that judgment shall have been rendered.

SECTION 2. This act shall take effect upon passage.