RI 2026 S2381: Insurance - Accident and Sickness Insurance Policies

Plain-English Summary

This legislation mandates that individual and group health insurance policies in Rhode Island provide coverage for services rendered by Certified Professional Midwives (CPMs). To qualify, the midwife must be certified by the North American Registry of Midwives and licensed by the state. The bill prohibits insurers from requiring supervision or referrals from other providers unless such requirements apply to all providers. Additionally, insurers must report utilization and cost data regarding these services to the Office of the Health Insurance Commissioner annually. These requirements go into effect for policies issued or renewed on or after January 1, 2027.

For younger readers

This new law says that health insurance companies must help pay for a special kind of helper for moms having babies, called a Certified Professional Midwife. A midwife is someone trained to help bring babies into the world safely. Before this law, insurance might not have paid for them, but starting in 2027, they have to treat these midwives like other doctors. This means families will have more choices and help paying for the care they want when having a baby.

Who & Where It Applies

Impacted groups

Pregnant women and familiesCertified Professional MidwivesHealth Insurance CompaniesHospital AdministratorsOffice of the Health Insurance Commissioner

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

Amount unknown

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Expands access to reproductive healthcare and birthing options, empowering women and birthing people to choose the care model that best suits their needs and cultural preferences.
Promotes equity in healthcare by ensuring that midwifery services, which are often lower-intervention and cost-effective, are covered by insurance rather than requiring out-of-pocket payment.
Removes hierarchical barriers by prohibiting insurers from requiring physician supervision for reimbursement, validating the professional autonomy of midwives.
Allows for reimbursement rates to be determined by insurers' existing mechanisms, which could result in low compensation that undervalues the labor of midwives.
Maintains the reliance on a private, profit-driven insurance market to access care, rather than establishing a universal guarantee of birthing support for all residents.
Includes a list of exempted insurance policy types (like limited benefit health), potentially leaving some vulnerable individuals without coverage for these services.

For Conservatives

Encourages market competition in healthcare by bringing more providers into the insurance system, potentially driving down overall costs associated with hospital births.
Supports family autonomy and traditional values by facilitating home births and midwifery care as viable alternatives to institutionalized medicine.
Reduces the regulatory monopoly of doctors and hospitals by preventing insurers from demanding unnecessary physician supervision for independent midwives.
Imposes a government mandate on private businesses (insurance companies), interfering with the free market and their right to determine what products they sell.
Likely to increase insurance premiums for all policyholders to cover the costs of these additional mandated services and reporting requirements.
Expands government bureaucracy by requiring the submission of annual utilization and cost reports to the specific state commissioner.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 167 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. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited to, §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

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. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

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. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, unless otherwise specified, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section: 27-41-101. Certified professional midwife.

(a) As used in this section, “certified professional midwife” or “CPM” means a trained professional who has successfully completed an accredited educational program in midwifery, holds a current certification as a certified professional midwife by the North American Registry of Midwives (hereinafter referred to in this section as “NARM”), and is licensed to practice midwifery in accordance with § 23-13-9.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2027, shall provide coverage for the services of a certified professional midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the certified professional midwife’s area of professional competence as defined by the standard developed and maintained by the Midwives Alliance of North America (hereinafter referred to in this section as “MANA”) in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient shall be required to pay for duplicate services actually rendered by both a licensed certified professional midwife and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover certified professional midwife services defined in subsections (a) and (b) of this section, shall report utilization and cost information related to licensed certified professional midwife’s services to the office of the health insurance commissioner on or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

(e) Notwithstanding any general or special law to the contrary, the provisions of this chapter shall supersede and shall control over any conflicting or inconsistent laws, including general laws, special laws, or local laws, or any rule or regulation of the state including, but not limited, to §§ 23-13-9, 27-41-2(21), 27-41-36 or any other state rule or regulation.

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