H 7862Health Insurance

Insurance - Healthcare Accessibility and Quality Assurance Act

This bill prevents health insurers from changing contract terms or payment rates for doctors without the doctor's written agreement.

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Introduced Feb 27, 2026Committee House Corporations

Plain-English Summary

This legislation prohibits health insurance companies and their vendors from changing the terms of a contract with a healthcare provider (such as a doctor or hospital) while the contract is active, unless the provider agrees in writing or the change is required by law. The bill defines "material terms" broadly to include payment rates, medical protocols, and billing requirements. If an insurer wishes to make changes not required by law, they must wait until the contract is up for renewal and provide at least 90 days' written notice.

For younger readers

Imagine you agreed to mow your neighbor's lawn for $10 all summer. This bill says the neighbor cannot suddenly decide to pay you only $5 or make you do extra work in the middle of the summer unless you say it is okay. It makes sure that health insurance companies stick to the promises they made to doctors in their contracts. They cannot change the rules or payment amounts until the contract time is over, unless the law says they must.

Who & Where It Applies

Impacted groups

Healthcare ProvidersHealth Insurance CompaniesPatientsMedical SpecialistsHospital Administrators

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

None

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Protects independent healthcare providers and community clinics from predatory corporate practices, ensuring they receive agreed-upon compensation without sudden cuts.
Enhances the stability of patient care by preventing insurers from abruptly changing coverage rules or medical necessity criteria that could disrupt treatment plans.
Reduces the administrative strain on healthcare workers, allowing them to focus more resources on patient well-being rather than navigating constantly shifting corporate policies.
Could hinder insurance companies from quickly implementing new cost-saving measures or efficiencies that might otherwise lower premiums for low-income families.
May lock in outdated medical protocols or administrative practices for the duration of a contract, potentially slowing the adoption of modernized, equitable care standards.
Reduces the system's flexibility to respond rapidly to public health crises if contract terms restrict the immediate updating of coverage policies.

For Conservatives

Upholds the sanctity of contracts by ensuring that agreements made between private parties are honored and cannot be arbitrarily altered by one side.
Supports small business owners and private medical practices by providing financial predictability and protecting them from corporate overreach.
Promotes a stable business environment where providers can plan their finances based on fixed terms rather than dealing with unpredictable regulatory shifts from insurers.
Represents government interference in private business negotiations by dictating exactly when and how contractual terms can be modified between private entities.
Limits the freedom of insurance companies to manage their provider networks and costs efficiently, which could result in higher prices for consumers.
Creates a rigid regulatory environment that stifles market innovation by preventing carriers from adapting their business models quickly to changing market conditions.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 22 additions

It is enacted by the General Assembly as follows:

SECTION 1. Chapter 27-18.8 of the General Laws entitled "Healthcare Accessibility and Quality Assurance Act" is hereby amended by adding thereto the following section: 27-18.8-3.1. Unilateral modification of provider contracts prohibited.

(a) No healthcare entity, as defined in § 27-18.8-2, including any affiliate, subsidiary, or contracted vendor acting on behalf of the healthcare entity, that offers, issues, or renews a health plan in this state, shall unilaterally modify, amend, or reinterpret any material term or condition of a contract with a healthcare provider, during the term of such contract.

(b) For purposes of this section, a "material term or condition" means and includes, but is not limited to, changes to reimbursement methodologies or underlying fee schedules; payment terms; carrier policies, protocols, or procedures; definitions of covered services or covered sites of service; utilization review requirements, prior authorization requirements, or medical necessity criteria; quality management or quality improvement requirements; credentialing requirements; billing or documentation requirements; clinical policy bulletins or coverage determination or covered preventive health services.

(c) Material terms and conditions shall include any policy, protocol, fee schedule, provider manual, or guidance incorporated by reference into the contract, whether issued electronically or otherwise.

(d) A healthcare entity may implement changes to a health carrier contract only:

(1) Upon the mutual written agreement of the healthcare entity and the healthcare provider; or

(2) Where such change is expressly required by state or federal law.

(e) Any change not required by law shall not take effect until the renewal of the contract term and then only if the healthcare entity has provided written notice of the proposed change at least ninety (90) days before the renewal.

SECTION 2. This act shall take effect upon passage.