The bipartisan legislation, introduced by state Sens. Dennis Algiere and Frank Lombardi, applies to surprise bills for nonemergency medical services that occur when an insured individual unknowingly receives care by an out-of-network provider at an in-network facility.
It requires the insured only pay out-of-pocket expenses that would be charged if care had been received by an in-network provider.
The bill also stipulates that Rhode Island’s health insurance commissioner develop a dispute resolution process for surprise bills or bills for emergency services.
Regarding an insured individual who received emergency services from a nonparticipating physician, that individual would not be required to pay “greater out-of-pocket costs for the emergency services than the insured would have incurred with a participating physician,” according to the bill.
Rhode Island is among the states that have looked at balance billing legislation. At least six states proposed, approved or moved through legislatures bills addressing surprise billing during the first quarter of this year.
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