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H 8308Health Insurance

Insurance - Primary Care Contracting Good Faith Act

Requires health insurers to negotiate contracts with primary care doctors every two years, considering inflation and operating costs.

Held for study
Population
Affected
72
Email Legislator
Introduced Mar 18, 2026Committee House Corporations

Plain-English Summary

This legislation, titled the "Primary Care Contracting Good Faith Act," establishes new rules for how health insurance payers must interact with primary care physician practices. It mandates that payers, including commercial insurers and Medicare advantage plans, negotiate contracts with these medical practices at least once every two years. These negotiations must account for rising operating costs, such as inflation and staff wages. Furthermore, the bill prohibits insurers from refusing to negotiate or contract with a practice based on its size, ownership, or the volume of Medicaid patients it serves. The Office of the Health Insurance Commissioner will oversee compliance.

For younger readers

This new rule helps family doctors stay in business. It says that the big insurance companies, who pay the bills when you visit the doctor, must talk to the doctors every two years to agree on fair payment. When they talk, the insurance companies have to think about how much things cost, like paying the nurses and the electric bill. It also says insurance companies cannot ignore a doctor just because their office is small or they help people who don't have much money. The government will watch to make sure everyone is being fair.

Who & Where It Applies

Impacted groups
Primary care physiciansCommercial insurersMedicare advantage plansManaged care organizationsMedicaid patients
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Protects access to healthcare for low-income individuals by prohibiting insurers from discriminating against practices that serve high volumes of Medicaid patients.
  • Mandates that negotiations explicitly consider staff wages, which could lead to better compensation for nurses, receptionists, and other healthcare workers in primary care settings.
  • Supports smaller, independent community-based practices against the market power of large corporate insurers, preventing consolidation that often hurts patient care.
  • Could lead to increased reimbursement rates that insurance companies might pass on to consumers in the form of higher premiums or out-of-pocket costs.
  • Relies on "good faith" negotiations without setting specific minimum reimbursement standards, which may not go far enough to guarantee the financial stability of safety-net providers.
  • Does not mandate that the increased revenue for practices be used to improve patient services or reduce costs for patients, rather than increasing profits for practice owners.
For Conservatives
  • Protects small business owners (independent physicians) from being bullied or ignored by large insurance conglomerates, promoting a more competitive market.
  • Ensures that business contracts account for economic realities like inflation and overhead costs, helping private practices remain financially viable.
  • Encourages private negotiation between parties rather than imposing strict government price controls on healthcare services.
  • Interferes with the free market and corporate freedom by dictating when private entities must negotiate and what factors they must consider in those contracts.
  • Expands the bureaucracy and oversight power of the Office of the Health Insurance Commissioner (OHIC) into private business dealings.
  • Increases the regulatory burden on businesses, which could drive up the cost of insurance and distort market dynamics.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 16 additions

SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended by adding thereto the following chapter: 27-84-1. Short title. This chapter shall be known and may be cited as the "Primary Care Contracting Good Faith Act." 27-84-2. Mandatory good-faith negotiations.

(a) As used in this chapter, the term "payer" means and includes commercial insurers, managed care organizations, and Medicare advantage plans.

(b) Every payer shall negotiate in good faith with any primary care physician practice at least once every twenty-four (24) months. Negotiations shall explicitly consider increases in operating costs, inflation, staff wages, malpractice premiums, and other overhead factors. 27-84-3. Prohibition on discriminatory refusals. A payer shall not refuse to negotiate or enter/renew a contract solely based on the practice’s size, ownership structure, patient panel size, or Medicaid volume. 27-84-4. Enforcement. The office of the health insurance commissioner (“OHIC”) shall maintain a negotiation request log and issue annual summary reports. Complaints shall be reviewed under existing OHIC authority.

SECTION 2. This act shall take effect ninety (90) days after passage.