AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES (Requires health insurance policies to cover licensed certified lactation counselor services for childbearing families. It would also prohibit requiring supervision or duplicate payments for services and mandates annual reporting.)

H7277

2026 -- H 7277
========
LC004236
========

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 Stewart, Donovan, Boylan, Hopkins, Cotter, Caldwell,
Fogarty, Cruz, Giraldo, and Place

Date Introduced:
January 23, 2026

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

27-18-96. Licensed certified lactation counselor.

4

(a) As used in this section, “licensed certified lactation counselor” means a trained
5
professional who holds a licensure and certification by the department of health in accordance with
6
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment,
7
evaluation, problem identification, treatment, education, and consultation to provide lactation care
8
and services to childbearing families, and infant children from birth to twelve (12) months old
9
within the scope of practice pursuant to the provisions of § 23-13.8-9.
10

(b) Every individual or group health insurance contract, or every individual or group
11
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
12
or renewed in this state on or after January 1, 2027, shall provide coverage for the services of
13
lactation counselors in accordance with each health insurers' respective principles and mechanisms
14
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors'
15
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation
16
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health
17
care provider. No insurer or hospital or medical service corporation may require supervision,
18
signature, or referral by any other health care provider as a condition of reimbursement, except
19
when those requirements are also applicable to other categories of health care providers. No insurer

1
or hospital or medical service corporation or patient may be required to pay for duplicate services
2
actually rendered by both a licensed certified lactation counselor and any other health care provider.
3

(c) Every individual or group health insurance contract, or every individual or group
4
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
5
or renewed in this state that is required to cover licensed certified lactation counselor services
6
defined in subsection (a) of this section, shall report utilization and cost information related to
7
licensed certified lactation counselor services to the office of the health insurance commissioner on
8
or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner
9
shall define the utilization and cost information required to be reported.
10

(d) This section shall not apply to insurance coverage providing benefits for:
11

(1) Hospital confinement indemnity;
12

(2) Disability income;
13

(3) Accident only;
14

(4) Long-term care;
15

(5) Medicare supplement;
16

(6) Limited benefit health;
17

(7) Specified disease indemnity;
18

(8) Sickness or bodily injury or death by accident or both; and
19

(9) Other limited benefit policies.
20
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
21
Corporations" is hereby amended by adding thereto the following section:
22

27-19-88. Licensed certified lactation counselor.

23

(a) As used in this section, “licensed certified lactation counselor” means a trained
24
professional who holds a licensure and certification by the department of health in accordance with
25
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment,
26
evaluation, problem identification, treatment, education, and consultation to provide lactation care
27
and services to childbearing families, and infant children from birth to twelve (12) months old
28
within the scope of practice pursuant to the provisions of § 23-13.8-9.
29

(b) Every individual or group health insurance contract, or every individual or group
30
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
31
or renewed in this state on or after January 1, 2027, shall provide coverage for the services of
32
lactation counselors in accordance with each health insurers' respective principles and mechanisms
33
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors'
34
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation

LC004236 - Page 2 of 6
1
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health
2
care provider. No insurer or hospital or medical service corporation may require supervision,
3
signature, or referral by any other health care provider as a condition of reimbursement, except
4
when those requirements are also applicable to other categories of health care providers. No insurer
5
or hospital or medical service corporation or patient may be required to pay for duplicate services
6
actually rendered by both a licensed certified lactation counselor and any other health care provider.
7

(c) Every individual or group health insurance contract, or every individual or group
8
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
9
or renewed in this state that is required to cover licensed certified lactation counselor services
10
defined in subsection (a) of this section, shall report utilization and cost information related to
11
licensed certified lactation counselor services to the office of the health insurance commissioner on
12
or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner
13
shall define the utilization and cost information required to be reported.
14

(d) This section shall not apply to insurance coverage providing benefits for:
15

(1) Hospital confinement indemnity;
16

(2) Disability income;
17

(3) Accident only;
18

(4) Long-term care;
19

(5) Medicare supplement;
20

(6) Limited benefit health;
21

(7) Specified disease indemnity;
22

(8) Sickness or bodily injury or death by accident or both; and
23

(9) Other limited benefit policies.
24
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
25
Corporations" is hereby amended by adding thereto the following section:
26

27-20-84. Licensed certified lactation counselor.

27

(a) As used in this section, “licensed certified lactation counselor” means a trained
28
professional who holds a licensure and certification by the department of health in accordance with
29
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment,
30
evaluation, problem identification, treatment, education, and consultation to provide lactation care
31
and services to childbearing families, and infant children from birth to twelve (12) months old
32
within the scope of practice pursuant to the provisions of § 23-13.8-9.
33

(b) Every individual or group health insurance contract, or every individual or group
34
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

LC004236 - Page 3 of 6
1
or renewed in this state on or after January 1, 2027, shall provide coverage for the services of
2
lactation counselors in accordance with each health insurers' respective principles and mechanisms
3
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors'
4
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation
5
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health
6
care provider. No insurer or hospital or medical service corporation may require supervision,
7
signature, or referral by any other health care provider as a condition of reimbursement, except
8
when those requirements are also applicable to other categories of health care providers. No insurer
9
or hospital or medical service corporation or patient may be required to pay for duplicate services
10
actually rendered by both a licensed certified lactation counselor and any other health care provider.
11

(c) Every individual or group health insurance contract, or every individual or group
12
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
13
or renewed in this state that is required to cover licensed certified lactation counselor services
14
defined in subsection (a) of this section, shall report utilization and cost information related to
15
licensed certified lactation counselor services to the office of the health insurance commissioner on
16
or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner
17
shall define the utilization and cost information required to be reported.
18

(d) This section shall not apply to insurance coverage providing benefits for:
19

(1) Hospital confinement indemnity;
20

(2) Disability income;
21

(3) Accident only;
22

(4) Long-term care;
23

(5) Medicare supplement;
24

(6) Limited benefit health;
25

(7) Specified disease indemnity;
26

(8) Sickness or bodily injury or death by accident or both; and
27

(9) Other limited benefit policies.
28
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance
29
Organizations" is hereby amended by adding thereto the following section:
30

27-41-101. Licensed certified lactation counselor.

31

(a) As used in this section, “licensed certified lactation counselor” means a trained
32
professional who holds a licensure and certification by the department of health in accordance with
33
chapter 13.8 of title 23. Licensed certified lactation counselors provide services in assessment,
34
evaluation, problem identification, treatment, education, and consultation to provide lactation care

LC004236 - Page 4 of 6
1
and services to childbearing families, and infant children from birth to twelve (12) months old
2
within the scope of practice pursuant to the provisions of § 23-13.8-9.
3

(b) Every individual or group health insurance contract, or every individual or group
4
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
5
or renewed in this state on or after January 1, 2027, shall provide coverage for the services of
6
lactation counselors in accordance with each health insurers' respective principles and mechanisms
7
of reimbursement, credentialing, and contracting, if the services are within the lactation counselors'
8
area of professional competence pursuant to the provisions of chapter 13.8 of title 23 ("lactation
9
counselor practice act of 2024"), and are currently reimbursed when rendered by any other health
10
care provider. No insurer or hospital or medical service corporation may require supervision,
11
signature, or referral by any other health care provider as a condition of reimbursement, except
12
when those requirements are also applicable to other categories of health care providers. No insurer
13
or hospital or medical service corporation or patient may be required to pay for duplicate services
14
actually rendered by both a licensed certified lactation counselor and any other health care provider.
15

(c) Every individual or group health insurance contract, or every individual or group
16
hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,
17
or renewed in this state that is required to cover licensed certified lactation counselor services
18
defined in subsection (a) of this section, shall report utilization and cost information related to
19
licensed certified lactation counselor services to the office of the health insurance commissioner on
20
or before July 1, 2027 and each July 1 thereafter. The office of the health insurance commissioner
21
shall define the utilization and cost information required to be reported.
22

(d) This section shall not apply to insurance coverage providing benefits for:
23

(1) Hospital confinement indemnity;
24

(2) Disability income;
25

(3) Accident only;
26

(4) Long-term care;
27

(5) Medicare supplement;
28

(6) Limited benefit health;
29

(7) Specified disease indemnity;
30

(8) Sickness or bodily injury or death by accident or both; and
31

(9) Other limited benefit policies.
32
SECTION 5. This act shall take effect on January 1, 2027.
========
LC004236
========

LC004236 - Page 5 of 6
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
***
1
This act would require health insurance policies to cover licensed certified lactation
2
counselor services for childbearing families. It would also prohibit requiring supervision or
3
duplicate payments for services and mandates annual reporting.
4
This act would take effect on January 1, 2027.
========
LC004236
========

LC004236 - Page 6 of 6