Skip to main content
H 8135Health Insurance

Insurance - Accident and Sickness Insurance Policies - Equal Pay for Healthcare Providers

This bill requires insurance companies and Medicaid to pay nurse practitioners and physician assistants the same rates as doctors for identical services.

Held for study
Population
Affected
35
Email Legislator
Introduced Feb 27, 2026Committee House Health & Human Services

Plain-English Summary

This legislation mandates that health insurance policies and the state Medicaid program reimburse certified nurse practitioners and licensed physician assistants at the same rate as physicians for performing the same services. This requirement applies specifically when these professionals are working in an independent practice and billing under their own names. The bill explicitly prohibits insurers from reducing physician payment rates to achieve this parity. Additionally, it directs the Executive Office of Health and Human Services to apply for necessary federal Medicaid waivers to implement these changes by January 1, 2027.

For younger readers

When you go to the doctor's office, you might see a nurse practitioner or a physician assistant instead of a doctor. They do a lot of the same things, like checking your health and giving you medicine. Right now, insurance companies often pay them less money than doctors for doing the same job. This new law says that if these workers have their own office, they must get paid the exact same amount as a doctor for doing the same work. It makes sure they are paid fairly for the help they give you.

Who & Where It Applies

Impacted groups
Nurse PractitionersPhysician AssistantsHealth Insurance CompaniesMedicaid RecipientsPhysicians
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Promotes economic justice by ensuring equal pay for equal work, recognizing that nurse practitioners and physician assistants provide vital services comparable to physicians and deserve equitable compensation.
  • Expands access to healthcare in underserved and low-income communities where nurse practitioners are often the primary source of medical care, thereby reducing health disparities.
  • Strengthens the social safety net by mandating these reimbursement rates within the Medicaid program, ensuring that the most vulnerable populations receive consistent, high-quality care from a broader range of providers.
  • May lead to increased health insurance premiums for working families as insurers pass on the higher costs of reimbursement to consumers.
  • Entrenches the fee-for-service model of healthcare rather than moving toward value-based care or a single-payer system that prioritizes patient outcomes over procedure volume.
  • Could incentivize providers to leave community health centers for independent private practice to capture higher reimbursement rates, potentially reducing staff in safety-net clinics.
For Conservatives
  • Encourages free market competition by breaking the monopoly physicians hold on higher reimbursement rates, allowing other qualified professionals to compete on a level playing field.
  • Supports small business owners and independent practitioners by ensuring they are compensated fairly for their services, fostering entrepreneurship in the healthcare sector.
  • Increases consumer choice by making it financially viable for more practitioners to open independent clinics, reducing reliance on large, consolidated hospital systems.
  • Represents heavy-handed government interference in the private market by dictating price controls and prohibiting insurers from negotiating their own reimbursement rates.
  • Increases the burden on taxpayers by mandating higher reimbursement rates for Medicaid services, which will inevitably drive up state spending.
  • Undermines the value of extensive medical school training by equating the financial value of services provided by non-physicians to those of fully trained doctors.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 97 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. Equal pay for healthcare providers.

(a) Whenever any policy of health insurance provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health service, provided by a licensed physician, the insured under the policy is entitled to reimbursement for such service, whether it is performed by a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the physician assistant or nurse practitioner.

(b) The reimbursement of a service described in subsection (a) of this section that is provided by a licensed physician assistant or a certified nurse practitioner who is in an independent practice shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served.

(c) As used in this section, “independent practice” means the provision of healthcare services to patients in a setting in which the licensed physician assistant or the certified nurse practitioner bills insurers for services identified by diagnosis and procedure codes using the physician assistant’s or nurse practitioner’s own name and national provider identifier.

(d) This section does not apply to group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other insurers that employ physicians, licensed physician assistants or certified nurse practitioners to provide primary care or mental health services and do not compensate such practitioners on a fee for-service basis.

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

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. Equal pay for healthcare providers.

(a) Whenever any policy of health insurance provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health service, provided by a licensed physician, the insured under the policy is entitled to reimbursement for such service, whether it is performed by a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the physician assistant or nurse practitioner.

(b) The reimbursement of a service described in subsection (a) of this section that is provided by a licensed physician assistant or a certified nurse practitioner who is in an independent practice shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served.

(c) As used in this section, “independent practice” means the provision of healthcare services to patients in a setting in which the licensed physician assistant or the certified nurse practitioner bills insurers for services identified by diagnosis and procedure codes using the physician assistant’s or nurse practitioner’s own name and national provider identifier.

(d) This section does not apply to group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other insurers that employ physicians, licensed physician assistants or certified nurse practitioners to provide primary care or mental health services and do not compensate such practitioners on a fee for-service basis.

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

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. Equal pay for healthcare providers.

(a) Whenever any policy of health insurance provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health service, provided by a licensed physician, the insured under the policy is entitled to reimbursement for such service, whether it is performed by a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the physician assistant or nurse practitioner.

(b) The reimbursement of a service described in subsection (a) of this section that is provided by a licensed physician assistant or a certified nurse practitioner who is in an independent practice shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served.

(c) As used in this section, “independent practice” means the provision of healthcare services to patients in a setting in which the licensed physician assistant or the certified nurse practitioner bills insurers for services identified by diagnosis and procedure codes using the physician assistant’s or nurse practitioner’s own name and national provider identifier.

(d) This section does not apply to group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other insurers that employ physicians, licensed physician assistants or certified nurse practitioners to provide primary care or mental health services and do not compensate such practitioners on a fee for-service basis.

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

SECTION 4. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby amended by adding thereto the following section: 40-8-33. Equal pay for healthcare providers.

(a) Beginning January 1, 2027, the executive office of health and human services (EOHHS) shall provide for reimbursement for any service which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health service, provided by a licensed physician, the insured under the policy is entitled to reimbursement for such service, whether it is performed by a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the physician assistant or nurse practitioner.

(b) The reimbursement of a service described in subsection (a) of this section that is provided by a licensed physician assistant or a certified nurse practitioner who is in an independent practice shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served.

(c) As used in this section, “independent practice” means the provision of healthcare services to patients in a setting in which the licensed physician assistant or the certified nurse practitioner bills insurers for services identified by diagnosis and procedure codes using the physician assistant’s or nurse practitioner’s own name and national provider identifier.

(d) The secretary of the EOHHS shall apply to the United States department of health and human services for any amendment to the state Medicaid plan or for any Medicaid waiver as necessary to implement this section. The secretary of the EOHHS shall submit the Medicaid state plan amendment on or before October 1, 2026.

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