AN ACT RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH (Commencing January 1, 2027, mandates insurers provide health insurance coverage without cost-share requirements for vaccinations recommended by the DOH and mandates the coverage for the medical assistance program and managed care organizations.)

H7625

2026 -- H 7625
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LC004819
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
A N A C T
RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH

Introduced By:
Representatives Donovan, Speakman, Boylan, Spears, Tanzi, Kislak,
Giraldo, Stewart, Fogarty, and Carson

Date Introduced:
February 11, 2026

Referred To:
House Health & Human Services
(Dept. of Health)
It is enacted by the General Assembly as follows:
1
SECTION 1. Section 23-1-44 of the General Laws in Chapter 23-1 entitled "Department
2
of Health" is hereby amended to read as follows:
3

23-1-44. Routine childhood and adult immunization vaccines.
4
(a) The department of health shall include in the department’s immunization program those
5
vaccines for routine childhood immunization as recommended by the Advisory Committee for
6
Immunization Practices (ACIP) and the Academy of Pediatrics (AAP)
or as determined by the
7
director of the department of health to be necessary to protect the public health
, and for routine
8
adult immunization as recommended by the ACIP,
or as determined by the director of the
9
department of health to be necessary to protect the public health

to the extent permitted by available
10
funds
. The immunization program includes administrative and quality assurance services and the
11
Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized
12
information system that is used to manage statewide immunizations, for all persons in Rhode
13
Island.
14
(b) The director of the department of health shall appoint an advisory committee that will
15
be convened
after the ACIP makes a recommendation regarding immunization

at the discretion of
16
the director
. The committee will review the ACIP recommendations
for the state

and director-
17
initiated proposals for the state
; assess the vaccine cost and feasibility; and advise the director of
18
health and the office of the health insurance commissioner regarding insurers and providers acting
19
on the
ACIP immunization recommendation

immunization recommendations or proposals
. All

1
recommendations will be posted on the department of health website. The advisory committee
2
membership shall include, but not be limited to, a primary care provider,
an epidemiologist, a

3
pharmacist,
major insurers, and at the discretion of the director,
representatives of the nursing home
4
industry
,

and
the home healthcare industry
and major insurers
.
5
(c) For the purpose of protecting patients’ information, all personally-identifiable
6
information obtained pursuant to this section shall be subject to the privacy protections of chapter
7
37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No.
8
104-191 (HIPAA), as amended.
9
SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance
10
Policies" is hereby amended by adding thereto the following section:
11

27-18-96. Coverage for vaccinations.

12

Every individual or group medical service contract or every individual or group hospital or
13
medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
14
on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
15
recommended by the Rhode Island department of health (RIDOH).
16
SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
17
Corporations" is hereby amended by adding thereto the following section:
18

27-19-88. Coverage for vaccinations.

19

Every individual or group medical service contract or every individual or group hospital or
20
medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
21
on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
22
recommended by the Rhode Island department of health (RIDOH).
23
SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
24
Corporations" is hereby amended by adding thereto the following section:
25

27-20-84. Coverage for vaccinations.

26

Every individual or group medical service contract or every individual or group hospital or
27
medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
28
on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
29
recommended by the Rhode Island department of health (RIDOH).
30
SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance
31
Organizations" is hereby amended by adding thereto the following section:
32

27-41-101. Coverage for vaccinations.

33

Every individual or group medical service contract or every individual or group hospital or
34
medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state

LC004819 - Page 2 of 5
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on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
2
recommended by the Rhode Island department of health (RIDOH).
3
SECTION 6. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby
4
amended by adding thereto the following section:
5

40-8-33. Coverage for vaccinations.

6

Commencing January 1, 2027, the medical assistance program shall provide coverage,
7
without cost-sharing, for all vaccinations recommended by the Rhode Island department of health
8
(RIDOH). This recommendation shall apply to all Medicaid beneficiaries, whether enrolled in fee-
9
for-service or managed care, to the extent permitted under federal law.
10
SECTION 7. Chapter 40-8.5 of the General Laws entitled "Health Care for Elderly and
11
Disabled Residents Act" is hereby amended by adding thereto the following section:
12

40-8.5-1.2. Coverage for vaccinations.

13

(a) As used herein, "managed care systems" is defined as systems that: integrate an efficient
14
financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate
15
care and deter unnecessary services; and place emphasis on preventive and primary care. For
16
purposes of this section, managed care systems may also be defined to include a primary care case-
17
management model, community health teams, and/or other such arrangements that meet standards
18
established by the executive office and serve the purposes of this section. Managed care systems
19
may also include services and supports that optimize the health and independence of beneficiaries
20
who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title (“long-
21
term care service reform for Medicaid eligible individuals”) or to be at risk for the care under the
22
applicable federal state plan or waiver authorities and the rules and regulations promulgated by the
23
executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance
24
may be provided such services through an entity certified by, or in a contractual arrangement with,
25
the executive office or, as deemed appropriate, exempt from mandatory managed care in
26
accordance with rules and regulations promulgated by the executive office.
27

(b) Commencing January 1, 2027, any Medicaid managed care organizations under
28
contract with the executive office of health and human services shall provide coverage, without
29
cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH),
30
to the extent permitted under federal law.
31
SECTION 8. Chapter 36-12 of the General Laws entitled "Insurance Benefits" is hereby
32
amended by adding thereto the following section:
33

36-12-2.1.1. Coverage for vaccinations.

34

Commencing January 1, 2027, the director of administration shall administer health benefit

LC004819 - Page 3 of 5
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programs for state employees and retirees, and shall ensure that coverage is provided, without cost-
2
sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).
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SECTION 9. Severability.
4
If any section of this act or its application to any person or circumstance is held invalid, the
5
invalidity shall not affect other sections or applications of the act that can be given effect without
6
the invalid section or application, and to this end the sections of this act are declared severable.
7
SECTION 10. This act shall take effect upon passage.
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LC004819 - Page 4 of 5
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH
***
1
Commencing January 1, 2027, this act would mandate insurers provide health insurance
2
coverage without cost-share requirements for vaccinations recommended by the state department
3
of health and would mandate the coverage for the medical assistance program and managed care
4
organizations.
5
This act would take effect upon passage.
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LC004819 - Page 5 of 5