Healthcare

Prohibits insurance companies from paying a rate that is less than the approved Medicaid rate set by the executive office of health and human services.

HB 7214 prohibits pharmacies, distributors, and sellers from charging "unreasonably excessive" prices for vital prescription drugs during declared market shortages. It defines "vital drugs" as those treating serious or life-threatening conditions with no available alternatives, and "market shortage" as inadequate supply meeting demand. Violators face felony charges, up to five years in prison, and $10,000 fines for intentionally exploiting shortages. The law requires governors to declare shortages via executive order, with penalties applying only to prices grossly above pre-shortage levels in the local area.

SB 2010 requires health insurers in Rhode Island to disclose how they use artificial intelligence (AI) to manage claims and coverage decisions, particularly for denials of medically necessary care. Insurers must document AI-driven decisions for five years, report system details to regulators, and ensure licensed healthcare providers review and approve any AI-related denial of medically necessary care before finalizing it. The bill mandates transparency about AI models, training data, and performance metrics, while requiring annual reports to the governor and legislature on insurer AI usage. This directly affects health insurers, enrollees (policyholders), and healthcare providers involved in coverage decisions.

Creates a 15 member commission to study and provide recommendations for safe staffing ratios in hospitals, who would report back to the General Assembly by March 31, 2027, and would expire on June 30, 2027.

SB 2101 establishes Rhode Island's Medical Primary Care Scholarship Program to address provider shortages. It provides up to five $70,000 annual scholarships per year for medical students and five $47,000 annual scholarships for nurse practitioner or physician assistant students. Recipients must agree to work in Rhode Island primary care for a period matching their scholarship duration (4 years for med students, 2 years for NPs/PAs) and sign a promissory note for funds received. The program, administered by the Department of Health and Commissioner of Postsecondary Education, aims to recruit and retain primary care providers to meet the state's growing healthcare needs.