RI 2026 H8381: Insurance - Accident and Sickness Insurance Policies

Plain-English Summary

This bill prevents dental insurance companies from forcing dentists to accept payments through methods that charge the dentist a fee, such as virtual credit cards. If an insurance company wants to use a fee-based payment method, it must inform the dentist of all alternative payment options, provide clear instructions on how to choose a different method, and obtain the dentist's explicit written consent. It also prohibits insurance plans and payment platforms from charging dentists fees just to access their claims data or to receive their payments.

For younger readers

Imagine doing a chore and someone pays you with a special gift card, but the store takes away some of your money just to use it. This bill stops dental insurance companies from doing that to your dentist. It says insurance companies cannot force dentists to get paid in ways that charge them hidden fees. If the insurance company wants to use a payment method with fees, they have to ask the dentist for permission first and offer other free ways to get paid, like an electronic bank transfer or a regular paper check.

Who & Where It Applies

Impacted groups

DentistsDental insurance companiesHealthcare payment platformsDental patientsHealth maintenance organizations

Impacted communities

All

Constitutional & Fiscal Check

None Likely. The bill regulates commercial contracts and payment processing between healthcare providers and insurance companies, which falls well within the state's traditional regulatory authority over the insurance industry and intrastate commerce.

Estimated cost

None

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Curbs predatory corporate behavior by preventing large insurance companies and payment platforms from forcing hidden fees onto independent healthcare providers.
Protects the financial stability of local dental practices, which helps maintain community access to dental care by preventing clinics from dropping insurance networks due to high overhead.
Promotes transparency in the healthcare system by requiring explicit written consent ("express acceptance") and clear communication of all payment options to providers.
Does not directly address or lower the out-of-pocket costs of dental care for patients, focusing solely on the business relationship between dentists and insurers.
Fails to expand dental coverage to uninsured or underinsured populations, missing an opportunity to strengthen the state's social safety net.
May inadvertently lead insurance companies to raise premiums on patients to recoup the lost revenue from the payment processing fees they previously collected.

For Conservatives

Protects small business owners (independent dentists) from coercive practices by large insurance corporations, allowing them to keep more of their rightfully earned revenue.
Defends the freedom of contract by ensuring that payment terms are mutually agreed upon through express acceptance rather than unilaterally mandated by insurers.
Reduces unnecessary administrative overhead for private dental practices, potentially promoting a freer, more competitive healthcare market without relying on government subsidies.
Imposes new government regulations on private insurance contracts, restricting the freedom of corporations to dictate their own payment processing methods.
Creates additional compliance burdens for insurance providers, who must now track express consent and maintain alternative payment systems, increasing administrative costs.
Interferes with the free market by legally prohibiting certain fee structures between private entities, rather than allowing the market to negotiate these terms naturally.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 152 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. Methods of payment.

(a) No contract between a dental plan or other healthcare entity and a dentist for the provision of services to beneficiaries shall require the dentist to accept payment exclusively by means of any form of payment method that requires dentists to pay fees or charges to release payment including virtual credit cards. A dental plan or other healthcare entity may initiate or change to a payment methodology that requires dentists to pay fees or charges to release payment, including virtual credit card payments, if the dental plan or healthcare entity:

(1) Informs the dentist of all available methods of payment;

(2) Provides clear and accessible instructions for the selection of an alternative method of payment;

(3) Ensures that the dentist may exercise such selection without restriction; and

(4) The provider or a designee of the provider elects, through express acceptance, to accept a payment of the claim using the credit card or electronic funds transfer payment method. Violation of express acceptance nullifies any election on claim payment methodology until such time as express agreement is executed.

(b) Neither the dental plan, the healthcare entity, nor any affiliated healthcare payments platform shall impose any fee or charge upon the dentist for access to payment or claims data; the transmission or processing of payment; or the issuance or mailing of payment.

(c) As used in this section, the following terms have the following meanings, unless the context clearly indicates otherwise:

(1) "Alternative payment method" means any form of payment other than virtual credit cards such as electronic funds transfers ("EFT") or automated clearing house payment ("ACH") or paper check.

(2) "Dental plan" means a policy or program that provides a specified level of dental benefits for procedures rendered by a dentist or hygienist, to a member or subscriber.

(3) "Dentist" means a licensed individual under chapter 31.1 of title 5 ("dentists and dental hygienists").

(4) "Express acceptance" means a clear and direct agreement to the terms of payment method, communicated explicitly by the dental plan to the dentist, in writing, signifying acceptance of the payment method without any ambiguity or implied actions.

(5) "Healthcare entity" means any for profit or nonprofit dental service corporation or any for profit or nonprofit hospital service corporation providing dental plans or any other entity providing dental plans and entering into provider contracts with dentists in the State of Rhode Island.

(6) "Healthcare payments platform" means any form of payment processor directly linked to or under contract with a healthcare entity.

(7) "Virtual credit card" means a form of electronic funds transfer utilizing a single-use series of numbers and specific payment amount which the payee is required to process manually.

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. Methods of payment.