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H7187 • 2026

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Edwards, Bennett, Potter, Carson, Fogarty, Casimiro
Last action
2026-02-03
Official status
Committee recommended measure be held for further study
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

What This Bill Does

  • AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-02-03 Committee

    Committee recommended measure be held for further study

  2. 2026-01-30 Rhode Island General Assembly

    Scheduled for hearing and/or consideration (02/03/2026)

  3. 2026-01-21 Rhode Island General Assembly

    Introduced, referred to House Health & Human Services

Official Summary Text

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Prohibits healthcare insurers from requiring or conducting a review for prescription medicine used to treat alcohol or opioid use disorder containing Methadone, Burenorphine, or Naltrexone, or approved to mitigate opioid withdrawal symptoms.)

Current Bill Text

Read the full stored bill text 
H7187

2026 -- H 7187
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LC004118
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
A N A C T
RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION
REVIEW ACT

Introduced By:
Representatives Edwards, Bennett, Potter, Carson, Fogarty, and Casimiro

Date Introduced:
January 21, 2026

Referred To:
House Health & Human Services
It is enacted by the General Assembly as follows:
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SECTION 1. Chapter 27-18.9 of the General Laws entitled "Benefit Determination and
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Utilization Review Act" is hereby amended by adding thereto the following section:
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27-18.9-17. Utilization review decisions.

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(a) A utilization review decision shall not retrospectively deny coverage for healthcare
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services provided to a covered person, when prior approval has been obtained from the insurer or
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its designee for those services, unless the approval was based upon fraudulent, materially
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inaccurate, or misrepresented information submitted by the covered person, authorized person, or
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the provider.
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(b) For health benefit plans issued or renewed on or after January 1, 2027, an insurer shall
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not require or conduct a prospective or concurrent review for a prescription medicine:
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(1) That is used in the treatment of alcohol or opioid use disorder;
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(2) That contains Methadone, Buprenorphine or Naltrexone; or
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(3) That was approved before January 1, 2027, by the United States Food and Drug
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Administration for the mitigation of opioid withdrawal symptoms.
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(c) In conducting utilization reviews for Medicaid benefits, each Medicaid managed care
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organization shall use the medical necessity criteria selected by the Rhode Island division of
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insurance for making determinations of medical necessity and clinical appropriateness pursuant to
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the utilization review plan.

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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 INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION
REVIEW ACT
***
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This act would prohibit healthcare insurers from requiring or conducting a review for
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prescription medicine that is used in the treatment of alcohol or opioid use disorder, that contains
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Methadone, Burenorphine, or Naltrexone or that was approved for the mitigation of opioid
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withdrawal symptoms, commencing January 1, 2027.
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This act would take effect upon passage.
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