R.I. Gen. Laws tit. 27, ch. 20 – Nonprofit Medical Service Corporations | Midpage

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Rhode Island General Laws

Chapter 27-20

R.I. Gen. Laws tit. 27, ch. 20

Nonprofit Medical Service Corporations

27-20-1Definitions 27-20-1.1Applicability 27-20-2Organization as charitable corporation — Insurance laws inapplicable 27-20-3Qualifications of directors 27-20-4Approval of articles of association 27-20-5Contracts with subscribers 27-20-5.1Cancellation of coverage by employers 27-20-5.3Patient responsibility — Administrative requirements 27-20-6Rates charged subscribers — Hearing by commissioner 27-20-6.1Uniform explanation of benefits and coverage 27-20-6.2Filing of policy forms 27-20-7Relationship of physician and patient — Actions against corporation 27-20-8Annual and quarterly statements 27-20-9Examination of affairs of corporation 27-20-10Commission plans for solicitors or insurance producers 27-20-11Investment standards 27-20-12Corporation deemed public charitable institution 27-20-13Adoption of chapter by hospital service corporation 27-20-14Coverage for adoptive children 27-20-15Itemized bills for services rendered 27-20-16Changing coverage 27-20-17Mammograms and pap smears — Coverage mandated 27-20-17.1Insurance coverage for postpartum hospital stays 27-20-18Mammograms — Quality assurance standards 27-20-19Pap smears — Quality assurance standards 27-20-20Coverage for infertility 27-20-21Nonprofit medical service corporation assessment 27-20-22Discontinuance of coverage — Chronic disabilities 27-20-23Drug coverage 27-20-23.1Medication synchronization 27-20-23.2Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies 27-20-23.3Patient choice in dispensing of clinician-administered drugs 27-20-24Rehabilitation, liquidation, or conservation 27-20-25Holding company systems 27-20-25.1No derogation of attorney general 27-20-25.2Health insurance rates 27-20-26Regulations 27-20-27New cancer therapies — Under investigation. [Repealed on effective date of § 27-20-64.]27-20-27.1“Reliable evidence” defined. [Repealed on effective date of § 27-20-64.]27-20-27.2Conditions of coverage. [Repealed on effective date of § 27-20-64.]27-20-27.3Managed care. [Repealed on effective date of § 27-20-64.]27-20-29Mastectomy treatment 27-20-29.1Insurance coverage for mastectomy hospital stays 27-20-30Diabetes treatment 27-20-31Primary and preventive obstetric and gynecological care 27-20-31.1Hysterectomy or myomectomy treatment 27-20-32Whistleblowers protection 27-20-33Penalties and remedies 27-20-34Additional relief and damages — Reinstatement 27-20-35Third-party reimbursement for services of certain healthcare workers 27-20-35.1Third-party reimbursement for services of registered nurse first assistants 27-20-36Human leukocyte antigen testing 27-20-37Drug coverage 27-20-37.1Specialty drugs 27-20-38Restricted annual rate payments prohibited 27-20-39Genetic testing 27-20-39.1Genetic information 27-20-41Magnetic resonance imaging — Quality assurance standards 27-20-42Acupuncture services 27-20-43FDA approved prescription contraceptive drugs and devices 27-20-44Prostate and colorectal examinations — Coverage mandated — The Maryellen Goodwin Colorectal Cancer Screening Act 27-20-45Eligibility for children’s benefits 27-20-46Hearing aids 27-20-47Prompt processing of claims 27-20-48Mandatory coverage for certain lyme disease treatments 27-20-49Dental insurance assignment of benefits 27-20-50Coverage for early intervention services 27-20-51Post-payment audits 27-20-52Reimbursement for orthotics and prosthetic services 27-20-53Tobacco cessation programs 27-20-54Mandatory coverage for scalp hair prosthesis 27-20-55Licensed ambulance service 27-20-56Enteral nutrition products 27-20-57Prohibition on preexisting condition exclusions 27-20-58Prohibition on rescission of coverage 27-20-59Annual and lifetime limits 27-20-60Coverage for individuals participating in approved clinical trials 27-20-61Medical loss ratio reporting and rebates 27-20-62Emergency services 27-20-63Internal and external appeal of adverse benefit determinations 27-20-65Primary care provider designation requirement 27-20-66Discretionary clauses 27-20-67Orally administered anticancer medication — Cost-sharing requirement 27-20-68Consumer notification 27-20-69Opioid antagonists 27-20-70Healthcare provider credentialing 27-20-71Unfair discrimination prohibited 27-20-72Health insurance contracts — Full year coverage for contraception 27-20-73Prohibition on discrimination in organ transplants 27-20-74Health insurance contracts — Copayments exemption for COVID-19 vaccinations 27-20-75Perinatal doulas 27-20-76Gender rating 27-20-77Coverage for biomarker testing 27-20-78Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome 27-20-79Coverage for treatment of pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection 27-20-81Dispensing and administration of HIV PrEP or PEP drugs 27-20-82Epinephrine injectors 27-20-83Acute mental health crisis mobile response and stabilization services. [Effective January 1, 2026.]