Rhode Island S3028: AN ACT RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE AND DISCIPLINE (Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.)

What the bill says

A bill or invoice. (2) "Date of receipt" means the date the healthcare entity or health plan receives the claim whether via electronic submission or as a paper claim. (3) "Healthcare entity" means a licensed insurance company or nonprofit hospital or medical or dental service corporation or plan or health maintenance organization, or a contractor as described in § 23-17.13-2(2) [repealed], that operates a health plan. (4) "Healthcare provider" means an individual clinician, either in practice independently or in a group, who provides healthcare services, and otherwise referred to as a non-inst.

From the introduced text, March 5, 2026:

a bill or invoice. (2) "Date of receipt" means the date the healthcare entity or health plan receives the claim whether via electronic submission or as a paper claim. (3) "Healthcare entity" means a licensed insurance company or nonprofit hospital or medical or dental service corporation or plan or health maintenance organization, or a contractor as described in § 23-17.13-2(2) [repealed], that operates a health plan. (4) "Healthcare provider" means an individual clinician, either in practice independently or in a group, who provides healthcare services, and otherwise referred to as a non-institutional provider. (5) "Healthcare services" include, but are not limited to, medical, mental health, substance LC006007 - Page 5 of abuse, dental, and any other services covered under the terms of the specific health plan. (6) "Health plan" means a plan operated by a healthcare entity that provides for the delivery of healthcare services to persons enrolled in those plans and/or (ii) Financial incentive for persons enrolled in the plan to use the participating providers and procedures provided for by the health plan. (7) "Policyholder" means a person covered under a health plan or a representative designated by that person. (8) "Substantial compliance" means that the healthcare entity or health plan is processing and paying ninety-five percent (95%) or more of all claims within the time frame provided for …

Read the full official text