S 2879Health Insurance

Businesses and Professions - The Primary Care Preservation Act

Doctors can charge patients extra fees for office tasks, and insurance companies cannot ban these charges.

Held for study

Population
Affected

Introduced Mar 4, 2026Committee Senate Health & Human Services

Plain-English Summary

This bill allows physician practices in Rhode Island to charge patients extra fees for administrative and operational tasks, such as scheduling appointments, coordinating care, and handling medical records. Insurance companies are prohibited from preventing doctors from charging these fees in their contracts or penalizing them for doing so. Doctors must disclose these fees to patients in advance. While insurance companies are not required to pay these fees, the bill ensures that doctors cannot deny emergency or urgent care to patients based on whether these fees are paid.

For younger readers

When you go to the doctor, usually your insurance pays for the visit. This new law lets doctor's offices ask you to pay extra money directly to them. This extra money pays for the work the office staff does, like answering phones, making appointments, and organizing your paperwork. Insurance companies are not allowed to tell doctors they can't charge this extra money. However, the doctor has to tell you about the cost before they charge you, and they still have to help you if you have a serious emergency.

Who & Where It Applies

Impacted groups

PatientsPhysiciansInsurance CompaniesMedical Office StaffPrimary Care Providers

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

Amount unknown

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Helps keep independent primary care practices financially viable, preventing them from being bought out by large corporate hospital systems that often have less accountability to the community.
Ensures that patients are informed upfront about administrative costs through mandatory disclosure requirements, increasing transparency in healthcare billing.
Protects access to emergency and urgent care by explicitly stating that failure to pay these administrative fees cannot be used as a reason to deny immediate, necessary medical treatment.
Increases out-of-pocket healthcare costs for patients, which disproportionately affects low-income individuals and families who are already struggling with medical expenses.
Creates a barrier to care that could lead to a two-tier health system where only wealthier patients can afford to maintain relationships with certain primary care physicians.
Undermines the social safety net provided by health insurance by allowing providers to unbundle services that were traditionally considered part of the overhead covered by standard reimbursement.

For Conservatives

Empowers small business owners (physicians) to set their own pricing models and revenue streams without interference from large insurance conglomerates.
Promotes free-market principles by allowing direct payment for services rendered, reducing reliance on third-party opaque reimbursement systems.
Encourages deregulation by voiding restrictive contract clauses that limit how a private business chooses to operate and bill its customers.
Represents government interference in private contractual relationships by declaring specific terms between private entities (insurers and doctors) null and void.
Uses vague language regarding "reasonable" fees, which could lead to billing disputes and increased litigation that clogs the court system.
May drive up the total cost of healthcare for the consumer, potentially leading to inflationary pressure on the medical sector.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 37 additions

SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" is hereby amended by adding thereto the following chapter: 5-37.9-1. Short title. This chapter shall be known and may be cited as "The Primary Care Preservation Act." 5-37.9-2. Definitions. As used in this chapter, the following words and terms shall have the meanings ascribed to them below unless the context clearly indicates otherwise:

(1) "Administrative or operational fee" means a reasonable charge assessed by a physician practice to patients for non-clinical services necessary to support operations including, but not limited to, reception, scheduling, care coordination, referral management, communication systems, record handling, and other administrative functions.

(2) "Payor" means any insurer, health maintenance organization, or other entity responsible for payment of healthcare services under a health plan.

(3) "Physician practice" means a medical practice owned or operated by one or more licensed physicians providing outpatient care in the State of Rhode Island. 5-37.9-3. Payor contract restrictions prohibited.

(a) No payor shall include in any contract, agreement, or participation document with a physician practice any clause or provision that prohibits, restricts, penalizes, or interferes with the ability of the practice to charge, bill, or collect a reasonable administrative or operational fee directly from patients.

(b) No payor shall impose conditions, penalties, or sanctions on a physician practice for assessing such fees, provided that the fees are disclosed to patients in advance and are not billed to the payor.

(c) Nothing in this section shall be construed to require a payor to reimburse a physician practice or patient for such fees. 5-37.9-4. Patient access and continuity of care.

(a) Nothing in this chapter shall limit a physician practice’s obligation to provide emergency or urgent care regardless of payment of any administrative or operational fee.

(b) Physician practices shall provide reasonable notice and access to patient medical records consistent with state and federal law. 5-37.9-5. Enforcement. Any provision in a payor contract that violates this chapter shall be deemed null and void and unenforceable as a matter of public policy. 5-37.9-6. Severability. If any clause, sentence, paragraph, section, or part of this chapter shall be adjudged by any court of competent jurisdiction to be invalid, that judgment shall not affect, impair, or invalidate the remainder of the chapter but shall be confined in its operation to the clause, sentence, paragraph, section, or part directly involved in the controversy in which that judgment shall have been rendered.

SECTION 2. This act shall take effect upon passage.