AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES (Caps amount payable for 30 day supply of equipment/supplies for insulin administration/glucose monitoring at $25 or equipment designed to last more than 30 days with no deductible commencing January 1, 2027.)

H7188

2026 -- H 7188
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LC004033
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Introduced By:
Representatives Kennedy, Donovan, Cotter, Fellela, Serpa, Diaz,
Ackerman, Edwards, Solomon, and Azzinaro

Date Introduced:
January 21, 2026

Referred To:
House Health & Human Services
It is enacted by the General Assembly as follows:
1
SECTION 1. Section 27-18-38 of the General Laws in Chapter 27-18 entitled "Accident
2
and Sickness Insurance Policies" is hereby amended to read as follows:
3

27-18-38. Diabetes treatment.
4
(a) Every individual or group health insurance contract, plan, or policy delivered, issued
5
for delivery, or renewed in this state that provides medical coverage that includes coverage for
6
physician services in a physician’s office, and every policy that provides major medical or similar
7
comprehensive-type coverage, except for supplemental policies that only provide coverage for
8
specified diseases and other supplemental policies, shall include coverage for the following
9
equipment and supplies for the treatment of insulin treated diabetes, non-insulin treated diabetes,
10
and gestational diabetes, if medically appropriate and prescribed by a physician: blood glucose
11
monitors and blood glucose monitors for the legally blind, test strips for glucose monitors and/or
12
visual reading, insulin, injection aids, cartridges for the legally blind, syringes, insulin pumps and
13
appurtenances to the pumps, insulin infusion devices, and oral agents for controlling blood sugar
14
and therapeutic/molded shoes for the prevention of amputation.
15
(b) Upon the approval of new or improved diabetes equipment and supplies by the Food
16
and Drug Administration, all policies governed by this section shall guarantee coverage of new
17
diabetes equipment and supplies when medically appropriate and prescribed by a physician. These
18
policies shall also include coverage, when medically necessary, for diabetes self-management
19
education to ensure that persons with diabetes are instructed in the self-management and treatment

1
of their diabetes, including information on the nutritional management of diabetes. The coverage
2
for self-management education and education relating to medical nutrition therapy shall be limited
3
to medically necessary visits upon the diagnosis of diabetes, where a physician diagnoses a
4
significant change in the patient’s symptoms or conditions that necessitates changes in a patient’s
5
self-management, or where reeducation or refresher training is necessary. This education, when
6
medically necessary and prescribed by a physician, may be provided only by the physician or, upon
7
the physician’s referral to an appropriately licensed and certified healthcare provider and may be
8
conducted in group settings. Coverage for self-management education and education relating to
9
medical nutrition therapy shall also include home visits when medically necessary.
10
(c) Benefit plans offered by an insurer may impose copayment and/or deductibles for the
11
benefits mandated by this chapter; however, in no instance shall the copayment or deductible
12
amount be greater than the copayment or deductible amount imposed for other supplies, equipment,
13
or physician office visits. Benefits for services under this section shall be reimbursed in accordance
14
with the respective principles and mechanisms of reimbursement for each insurer, hospital, or
15
medical service corporation, or health maintenance organization.
16

(d) Commencing January 1, 2027, coverage for equipment and supplies for insulin
17
administration and glucose monitoring shall have a cap on the amount that a covered person is
18
required to pay for such equipment and supplies at no more than twenty-five dollars ($25.00) per a
19
supply lasting thirty (30) days, or per item when an item is intended to be used for longer than thirty
20
(30) days. Coverage for such equipment and supplies shall not be subject to any annual deductible.
21
If the application of the cap to a specific item of equipment or supply before a covered person has
22
met their plan's deductible would result in health savings account ineligibility under 26 U.S.C. §
23
223, then the cap would only apply to that specific item of equipment or supply after the covered
24
person has met their plan's deductible.
25
SECTION 2. Section 27-19-35 of the General Laws in Chapter 27-19 entitled "Nonprofit
26
Hospital Service Corporations" is hereby amended to read as follows:
27

27-19-35. Diabetes treatment.
28
(a) Every individual or group health insurance contract, plan, or policy delivered, issued
29
for delivery, or renewed in this state that provides medical coverage that includes coverage for
30
physician services in a physician’s office, and every policy that provides major medical or similar
31
comprehensive-type coverage shall include coverage for the following equipment and supplies for
32
the treatment of insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes when
33
medically appropriate and prescribed by a physician: blood glucose monitors and blood glucose
34
monitors for the legally blind, test strips for glucose monitors and/or visual reading, insulin,

LC004033 - Page 2 of 7
1
injection aids, cartridges for the legally blind, syringes, insulin pumps and appurtenances to the
2
pumps, insulin infusion devices, and oral agents for controlling blood sugar and therapeutic/molded
3
shoes for the prevention of amputation. Upon the approval of new or improved diabetes equipment
4
and supplies by the Food and Drug Administration, all policies governed by this chapter shall
5
guarantee coverage of new diabetes equipment and supplies when medically appropriate and
6
prescribed by a physician. The policies shall also include coverage, when medically necessary, for
7
diabetes self-management education to ensure that persons with diabetes are instructed in the self-
8
management and treatment of their diabetes, including information on the nutritional management
9
of diabetes. The coverage for self-management education and education relating to medical
10
nutrition therapy shall be limited to medically necessary visits upon the diagnosis of diabetes, where
11
a physician diagnoses a significant change in the patient’s symptoms or conditions that necessitates
12
changes in a patient’s self-management, or where reeducation or refresher training is necessary.
13
This education, when medically necessary and prescribed by a physician, may be provided only by
14
the physician or upon his or her referral by an appropriately licensed and certified healthcare
15
provider and may be conducted in group settings. Coverage for self-management education and
16
education relating to medical nutrition therapy shall also include home visits when medically
17
necessary.
18
(b) Benefit plans offered by a hospital service corporation may impose copayment or
19
deductibles, or both, for the benefits mandated by this chapter, however, in no instance shall the
20
copayment or deductible amount be greater than the copayment or deductible amount imposed for
21
other supplies, equipment, or physician office visits. Benefits for services under this chapter shall
22
be reimbursed in accordance with the respective principles and mechanisms of reimbursement for
23
each insurer, hospital, or medical service corporation, or health maintenance organization.
24

(c) Commencing January 1, 2027, coverage for equipment and supplies for insulin
25
administration and glucose monitoring shall have a cap on the amount that a covered person is
26
required to pay for such equipment and supplies at no more than twenty-five dollars ($25.00) per a
27
supply lasting thirty (30) days, or per item when an item is intended to be used for longer than thirty
28
(30) days. Coverage for such equipment and supplies shall not be subject to any annual deductible.
29
If the application of the cap to a specific item of equipment or supply before a covered person has
30
met their plan's deductible would result in health savings account ineligibility under 26 U.S.C. §
31
223, then the cap would only apply to that specific item of equipment or supply after the covered
32
person has met their plan's deductible.
33
SECTION 3. Section 27-20-30 of the General Laws in Chapter 27-20 entitled "Nonprofit
34
Medical Service Corporations" is hereby amended to read as follows:

LC004033 - Page 3 of 7
1

27-20-30. Diabetes treatment.
2
(a) Every individual or group health insurance contract, plan, or policy delivered, issued
3
for delivery, or renewed in this state that provides medical coverage that includes coverage for
4
physician services in a physician’s office, and every policy that provides major medical or similar
5
comprehensive-type coverage, shall include coverage for the following equipment and supplies for
6
the treatment of insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes when
7
medically appropriate and prescribed by a physician: blood glucose monitors and blood glucose
8
monitors for the legally blind; test strips for glucose monitors and/or visual reading, insulin,
9
injection aids, cartridges for the legally blind, syringes, insulin pumps, and appurtenances to the
10
pumps, insulin infusion devices, and oral agents for controlling blood sugar and therapeutic/molded
11
shoes for the prevention of amputation. Upon the approval of new or improved diabetes equipment
12
and supplies by the Food and Drug Administration, all policies governed by this chapter shall
13
guarantee coverage of new diabetes equipment and supplies when medically appropriate and
14
prescribed by a physician. These policies shall also include coverage, when medically necessary,
15
for diabetes self-management education to ensure that persons with diabetes are instructed in the
16
self-management and treatment of their diabetes, including information on the nutritional
17
management of diabetes. The coverage for self-management education and education relating to
18
medical nutrition therapy shall be limited to medically necessary visits upon the diagnosis of
19
diabetes, where a physician diagnoses a significant change in the patient’s symptoms or conditions
20
that necessitates changes in a patient’s self-management, or where reeducation or refresher training
21
is necessary. This education, when medically necessary and prescribed by a physician, may be
22
provided only by the physician or, upon his or her referral, to an appropriately licensed and certified
23
healthcare provider, and may be conducted in group settings. Coverage for self-management
24
education and education relating to medical nutrition therapy shall also include home visits when
25
medically necessary.
26
(b) Benefit plans offered by a medical service corporation may impose copayment or
27
deductibles or both for the benefits mandated by this chapter, however, in no instance shall the
28
copayment or deductible amount be greater than the copayment or deductible amount imposed for
29
other supplies, equipment, or physician office visits. Benefits for services under this chapter shall
30
be reimbursed in accordance with the respective principles and mechanisms of reimbursement for
31
each insurer, hospital, or medical service corporation, or health maintenance organization.
32

(c) Commencing January 1, 2027, coverage for equipment and supplies for insulin
33
administration and glucose monitoring shall have a cap on the amount that a covered person is
34
required to pay for such equipment and supplies at no more than twenty-five dollars ($25.00) per a

LC004033 - Page 4 of 7
1
supply lasting thirty (30) days, or per item when an item is intended to be used for longer than thirty
2
(30) days. Coverage for such equipment and supplies shall not be subject to any annual deductible.
3
If the application of the cap to a specific item of equipment or supply before a covered person has
4
met their plan's deductible would result in health savings account ineligibility under 26 U.S.C. §
5
223, then the cap would only apply to that specific item of equipment or supply after the covered
6
person has met their plan's deductible.
7
SECTION 4. Section 27-41-44 of the General Laws in Chapter 27-41 entitled "Health
8
Maintenance Organizations" is hereby amended to read as follows:
9

27-41-44. Diabetes treatment.
10
(a) Every individual or group health insurance contract, plan, or policy delivered, issued
11
for delivery, or renewed in this state that provides medical coverage that includes coverage for
12
physician services in a physician’s office and every policy that provides major medical or similar
13
comprehensive-type coverage shall include coverage for the following equipment and supplies for
14
the treatment of insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes when
15
medically appropriate and prescribed by a physician: blood glucose monitors and blood glucose
16
monitors for the legally blind, test strips for glucose monitors and visual reading, insulin, injection
17
aids, cartridges for the legally blind, syringes, insulin pumps and appurtenances to them, insulin
18
infusion devices, oral agents for controlling blood sugar, and therapeutic/molded shoes for the
19
prevention of amputation. Upon the approval of new or improved diabetes equipment and supplies
20
by the Food and Drug Administration, all policies governed by this chapter shall guarantee
21
coverage of this new diabetes equipment and supplies when medically appropriate and prescribed
22
by a physician. These policies shall also include coverage, when medically necessary, for diabetes
23
self-management education to ensure that persons with diabetes are instructed in the self-
24
management and treatment of their diabetes, including information on the nutritional management
25
of diabetes. This coverage for self-management education and education relating to medical
26
nutrition therapy shall be limited to medically necessary visits upon the diagnosis of diabetes, where
27
a physician diagnoses a significant change in the patient’s symptoms or conditions that necessitates
28
changes in a patient’s self-management, or where reeducation or refresher training is necessary.
29
This education, when medically necessary and prescribed by a physician, may be provided only by
30
the physician or, upon his or her referral to an appropriately licensed and certified healthcare
31
provider and may be conducted in group settings. Coverage for self-management education and
32
education relating to medical nutrition therapy shall also include home visits when medically
33
necessary.
34
(b) Benefit plans offered by a health maintenance organization may impose copayment or

LC004033 - Page 5 of 7
1
deductibles, or both, for the benefits mandated by this chapter. However, in no instance shall the
2
copayment or deductible amount be greater than the copayment or deductible amount imposed for
3
other supplies, equipment, or physician office visits. Benefits for services under this chapter shall
4
be reimbursed in accordance with the respective principles and mechanisms of reimbursement for
5
each insurer, hospital, or medical service corporation, or health maintenance organization.
6

(c) Commencing January 1, 2027, coverage for equipment and supplies for insulin
7
administration and glucose monitoring shall have a cap on the amount that a covered person is
8
required to pay for such equipment and supplies at no more than twenty-five dollars ($25.00) per a
9
supply lasting thirty (30) days, or per item when an item is intended to be used for longer than thirty
10
(30) days. Coverage for such equipment and supplies shall not be subject to any annual deductible.
11
If the application of the cap to a specific item of equipment or supply before a covered person has
12
met their plan's deductible would result in health savings account ineligibility under 26 U.S.C. §
13
223, then the cap would only apply to that specific item of equipment or supply after the covered
14
person has met their plan's deductible.
15
SECTION 5. Chapter 36-12 of the General Laws entitled "Insurance Benefits" is hereby
16
amended by adding thereto the following section:
17

36-12-2.6. Health insurance benefits - Diabetes treatment.

18

Commencing on and after January 1, 2027, when the health insurance plan for employees
19
of the State of Rhode Island is purchased or renewed by the director of administration pursuant to
20
§ 36-12-6, the plan shall provide for the coverage of equipment and supplies for insulin
21
administration and glucose monitoring, and shall have a cap on the amount that a covered person
22
is required to pay for such equipment and supplies at no more than twenty-five dollars ($25.00) per
23
a supply lasting thirty (30) days, or per item when an item is intended to be used for longer than
24
thirty (30) days. Coverage for such equipment and supplies shall not be subject to any annual
25
deductible. If the application of the cap to a specific item of equipment or supply before a covered
26
person has met their plan's deductible would result in health savings account ineligibility under 26
27
U.S.C. § 223, then the cap would only apply to that specific item of equipment or supply after the
28
covered person has met their plan's deductible.
29
SECTION 6. This act shall take effect on January 1, 2027.
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LC004033
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LC004033 - Page 6 of 7
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
***
1
This act would cap the amount that a covered person is required to pay for insulin
2
administration and glucose monitoring equipment and supplies at twenty-five dollars ($25.00) per
3
thirty (30) day supply or per item when an item is intended to be used for longer than thirty (30)
4
days and would prohibit any deductible for the equipment and supplies. The coverage would
5
commence on January 1, 2027.
6
This act would take effect on January 1, 2027.
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LC004033
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LC004033 - Page 7 of 7