AN ACT RELATING TO COMMERCIAL LAW -- GENERAL REGULATORY PROVISIONS -- PATIENT BROKERING ACT (Prohibits the practice of patient brokering and provides monetary penalties and enforcement by the office of the attorney general.)

H7109

2026 -- H 7109
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LC003761
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO COMMERCIAL LAW -- GENERAL REGULATORY PROVISIONS --
PATIENT BROKERING ACT

Introduced By:
Representatives J. Lombardi, Hull, Sanchez, Cruz, and Stewart

Date Introduced:
January 15, 2026

Referred To:
House Corporations
It is enacted by the General Assembly as follows:
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SECTION 1. Title 6 of the General Laws entitled "COMMERCIAL LAW -- GENERAL
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REGULATORY PROVISIONS" is hereby amended by adding thereto the following chapter:
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CHAPTER 13.4
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PATIENT BROKERING ACT
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6-13.4-1. Definitions.

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The following words as used in this chapter, unless a different meaning is required by the
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context or is specifically prescribed, shall have the following meanings:
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(1) "Health care provider" means any person or entity licensed, certified, or registered;
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required to be licensed, certified or registered; or lawfully exempt from being required to be
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licensed, certified or registered with the department of health; any person or entity that has
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contracted with the department of health to provide goods or services to Medicaid recipients
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pursuant to Rhode Island law; any provider of behavioral health care services provided by the
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department of behavioral health care, developmental disabilities and hospitals; or any federally
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supported primary care program authorized under 42 U.S.C. Chapter 6A, "Public Health Service."
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(2) "Health care provider network entity" means a corporation, partnership, or limited
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liability company owned or operated by two (2) or more health care providers and organized for
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the purpose of entering into agreements with health insurers, health care purchasing groups, or the
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Medicare or Medicaid program.

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(3) "Health insurer" means any insurance company authorized to transact health insurance
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in the state, any insurance company authorized to transact health insurance or casualty insurance in
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the state that is offering a minimum premium plan or stop-loss coverage for any person or entity
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providing health care benefits, any self-insurance plan as defined in title 27, any health maintenance
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organization, any prepaid health clinic, any prepaid limited health service organization, any
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multiple-employer welfare arrangement authorized to transact business in the state pursuant to title
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27, or any fraternal benefit society lawfully providing health benefits to its members.
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6-13.4-2. Patient brokering prohibited.

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It is an unfair sales practice for any person, including any health care provider or health
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care facility, to:
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(1) Offer or pay a commission, benefit, bonus, rebate, kickback, or bribe, directly or
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indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, to
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induce the referral of a patient or patronage to or from a health care provider or health care facility;
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(2) Solicit or receive a commission, benefit, bonus, rebate, kickback, or bribe, directly or
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indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in
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return for referring a patient or patronage to or from a health care provider or health care facility;
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(3) Solicit or receive a commission, benefit, bonus, rebate, kickback, or bribe, directly or
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indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in
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return for the acceptance or acknowledgement of treatment from a health care provider or health
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care facility; or
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(4) Aid, abet, advise, or otherwise participate in the conduct prohibited under this section.
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6-13.4-3. Exceptions.

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This chapter shall not apply to:
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(1) Any discount, payment, waiver of payment, or payment practice not prohibited by 42
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U.S.C. § 1320a-7b(b) or regulations promulgated thereunder.
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(2) Any payment, compensation, or financial arrangement within a group practice,
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provided such payment, compensation, or arrangement is not to or from persons who are not
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members of the group practice.
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(3) Payments to a health care provider or health care facility for professional consultation
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services.
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(4) Commissions, fees, or other remuneration lawfully paid to insurance agents as provided
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under title 27.
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(5) Payments by a health insurer who reimburses, provides, offers to provide, or
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administers health, mental health, or substance abuse goods or services under a health benefit plan.

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(6) Payments to or by a health care provider or health care facility, or a health care provider
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network entity, that has contracted with a health insurer, a health care purchasing group, or the
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Medicare or Medicaid program to provide health, metal health, or substance abuse goods or
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services under a health benefit plan when such payments are for goods or services under the plan;
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provided however, that nothing in this section shall affect whether a health care provider network
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entity is an insurer required to be licensed under Rhode Island law.
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(7) Insurance advertising gifts lawfully permitted under title 27.
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(8) When applicable, commissions or fees paid to a nurse registry licensed pursuant to the
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department of health for referring persons providing health care services to clients of the nurse
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registry.
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(9) Payments by a health care provider or health care facility to a health, mental health, or
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substance abuse information service that provides information upon request and without charge to
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consumers about providers of health care goods or services to enable consumers to select
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appropriate providers or facilities, provided that, such information service:
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(i) Does not attempt through its standard questions for solicitation of consumer criteria or
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through any other means to steer or lead a consumer to select or consider selection of a particular
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health care provider or health care facility;
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(ii) Does not provide or represent itself as providing diagnostic or counseling services or
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assessments of illness or injury and does not make any promises of cure or guarantees of treatment;
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(iii) Does not provide or arrange for transportation of a consumer to or from the location
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of a health care provider or health care facility; and
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(iv) Charges and collects fees from a health care provider or health care facility
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participating in its services that are set in advance, are consistent with the fair market value for
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those information services, and are not based on the potential value of a patient or patients to a
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health care provider or health care facility or of the goods or services provided by the health care
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provider or health care facility.
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(10) An individual employed by the assisted living facility, or with whom the facility
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contracts to provide marketing services for the facility, if the individual clearly indicates that they
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work with or for the facility.
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(11) Payments by an assisted living facility to a referral service that provides information,
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consultation, or referrals to consumers to assist them in finding appropriate care or housing options
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for seniors or disabled adults if the referred consumers are not Medicaid recipients.
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(12) A resident of an assisted living facility who refers a friend, family members, or other
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individuals with whom the resident has a personal relationship to the assisted living facility, in

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which case the assisted living facility may provide a monetary reward to the resident for making
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such referral.
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6-13.4-4. Penalties - Enforcement.

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(a) Any person, including an officer, partner, agent, attorney or other representative of a
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firm, joint venture, partnership, business trust, syndicate, corporation, or other business entity, who
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violates any provision of this chapter commits a felony and shall, in addition to any criminal
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sentence imposed, be ordered to pay a fine of fifty thousand dollars ($50,000) for a violation
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involving fewer than ten (10) patients; one hundred thousand dollars ($100,000) for a violation
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involving between ten (10) and fewer than twenty (20) patients; and five hundred thousand dollars
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($500,000) for any violation where the prohibited conduct involves twenty (20) or more patients.
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(b) Notwithstanding the existence or pursuit of any other remedy, the Rhode Island attorney
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general may maintain an action for injunctive or other process to enforce the provisions of this
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chapter.
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(c) The party bringing an action under this chapter may recover reasonable expenses in
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obtaining injunctive relief, including, but not limited to, investigative costs, court costs, reasonable
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attorneys' fees, witness costs, and deposition expenses.
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(d) The provisions of this chapter are in addition to any other civil, administrative, or
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criminal actions provided by law and may be imposed against both corporate and individual
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defendants.
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SECTION 2. This act shall take effect upon passage.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO COMMERCIAL LAW -- GENERAL REGULATORY PROVISIONS --
PATIENT BROKERING ACT
***
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This act would prohibit the practice of patient brokering and would provide monetary
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penalties and enforcement by the office of the attorney general.
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This act would take effect upon passage.
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