S 3089Health Insurance

Insurance - Healthcare Accessibility and Quality Assurance Act

Health insurers are prohibited from changing contract terms with providers without mutual agreement until the contract renews.

Held for study

Population
Affected

Email Legislator

Introduced Mar 13, 2026Committee Senate Health & Human Services

Plain-English Summary

This legislation prevents health insurance companies from changing the terms of a contract with a healthcare provider (like a doctor or hospital) while the contract is active, unless the provider agrees in writing. Currently, insurers might unilaterally change payment rates or rules. Under this bill, "material terms" such as fee schedules, authorization requirements, and billing rules cannot be changed by the insurer alone. Changes not required by law can only happen when the contract is up for renewal, provided the insurer gives 90 days' notice.

For younger readers

Imagine you agreed to mow your neighbor's lawn for $10 all summer. But halfway through the summer, the neighbor decided to only pay you $5 without asking you first. That wouldn't be fair! This bill stops health insurance companies from doing that to doctors. Once they sign a contract, the insurance company cannot change the rules or how much they pay the doctor until the contract is over, unless the doctor agrees to the change in writing. It makes sure everyone sticks to the deal they signed.

Who & Where It Applies

Impacted groups

Healthcare providersHealth insurance companiesMedical practice administratorsPatientsHospitals

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

None

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Protects independent medical practices and community clinics from financial instability caused by large insurance corporations arbitrarily cutting reimbursement rates.
Ensures greater stability in the healthcare network, preventing situations where providers are forced to drop insurance coverage suddenly, which protects patient access to care.
Reduces the power imbalance between massive corporate entities and individual healthcare workers by requiring mutual consent for contract changes.
May hinder insurance carriers from quickly implementing new quality improvement protocols or necessary cost-saving measures during a contract term.
Could potentially lead to higher insurance premiums for the public if carriers lock in higher reimbursement rates to hedge against the inability to adjust them later.
Reduces flexibility for insurers to update coverage definitions rapidly in response to emerging public health data if the provider does not agree.

For Conservatives

Upholds the sanctity of contracts by ensuring that terms agreed upon cannot be arbitrarily changed by one party without mutual consent.
Protects small business owners, such as private medical practices, from unpredictable revenue changes imposed by large insurance entities.
Promotes market stability by requiring clear, fixed terms for the duration of a business agreement, allowing for better financial planning.
Represents government interference in private business negotiations between private entities, restricting the free market.
Prevents insurance companies from rapidly adjusting business strategies and fee schedules to react to market conditions or economic shifts.
Imposes strict regulatory burdens on businesses, dictating specific notice periods and consent requirements for operational changes.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 22 additions

SECTION 1. Chapter 27-18.8 of the General Laws entitled "Healthcare Accessibility and Quality Assurance Act" is hereby amended by adding thereto the following section: 27-18.8-3.1. Unilateral modification of provider contracts prohibited.

(a) No healthcare entity, as defined in § 27-18.8-2, including any affiliate, subsidiary, or contracted vendor acting on behalf of the healthcare entity, that offers, issues, or renews a health plan in this state, shall unilaterally modify, amend, or reinterpret any material term or condition of a contract with a healthcare provider, during the term of such contract.

(b) For purposes of this section, a "material term or condition" means and includes, but is not limited to, changes to reimbursement methodologies or underlying fee schedules; payment terms; carrier policies, protocols, or procedures; definitions of covered services or covered sites of service; utilization review requirements, prior authorization requirements, or medical necessity criteria; quality management or quality improvement requirements; credentialing requirements; billing or documentation requirements; clinical policy bulletins or coverage determination or covered preventive health services.

(c) Material terms and conditions shall include any policy, protocol, fee schedule, provider manual, or guidance incorporated by reference into the contract, whether issued electronically or otherwise.

(d) A healthcare entity may implement changes to a health carrier contract only:

(1) Upon the mutual written agreement of the healthcare entity and the healthcare provider; or

(2) Where such change is expressly required by state or federal law.

(e) Any change not required by law shall not take effect until the renewal of the contract term and then only if the healthcare entity has provided written notice of the proposed change at least ninety (90) days before the renewal.

SECTION 2. This act shall take effect upon passage.