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H7625A
2026 -- H 7625 SUBSTITUTE A
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LC004819/SUB A/2
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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 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:
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SECTION 1. Section 23-1-44 of the General Laws in Chapter 23-1 entitled "Department
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of Health" is hereby amended to read as follows:
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23-1-44. Routine childhood and adult immunization vaccines.
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(a) The department of health shall include in the department’s immunization program those
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vaccines for routine childhood immunization as recommended by the Advisory Committee for
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Immunization Practices (ACIP) and the Academy of Pediatrics (AAP)
or as determined by the
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director of the department of health to be necessary to protect the public health
, and for routine
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adult immunization as recommended by the ACIP,
or as determined by the director of the
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department of health to be necessary to protect the public health
to the extent permitted by available
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funds
. The immunization program includes administrative and quality assurance services and the
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Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized
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information system that is used to manage statewide immunizations, for all persons in Rhode
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Island.
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(b) The director of the department of health shall appoint an advisory committee that will
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be convened
after the ACIP makes a recommendation regarding immunization
at the discretion of
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the director
. The committee will review the ACIP recommendations
for the state
and director-
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initiated proposals for the state
; assess the vaccine cost and feasibility; and advise the director of
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health and the office of the health insurance commissioner regarding insurers and providers acting
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on the
ACIP immunization recommendation
immunization recommendations or proposals
. All
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recommendations will be posted on the department of health website. The advisory committee
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membership shall include, but not be limited to, a primary care provider,
an epidemiologist, a
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pharmacist,
major insurers, and at the discretion of the director,
representatives of the nursing home
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industry
,
and
the home healthcare industry
and major insurers
.
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(c) For the purpose of protecting patients’ information, all personally-identifiable
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information obtained pursuant to this section shall be subject to the privacy protections of chapter
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37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No.
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104-191 (HIPAA), as amended.
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SECTION 2. Section 23-101-2 of the General Laws in Chapter 23-101 entitled "Healthcare
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Provider Shield" is hereby amended to read as follows:
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23-101-2. Definitions.
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As used in this chapter, the followings words shall have the following meanings unless the
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context clearly indicates otherwise:
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(1) “Aggrieved person” means:
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(i) A person against whom hostile litigation is filed or prosecuted or the legal representative
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of a person against whom hostile litigation is filed or prosecuted; or
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(ii) The employer of a person against whom hostile litigation is filed or prosecuted if the
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legally protected healthcare activity or aiding and assisting legally protected healthcare activity of
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the person that forms the basis of the hostile litigation was performed within the scope of the
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person’s employment.
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(2) “Aid and assist legally protected healthcare activity” and “aiding and assisting legally
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protected healthcare activity” mean:
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(i) Any act or omission of a person aiding or effectuating or attempting to aid or effectuate
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any other person in legally protected healthcare activity;
or
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(ii) The provision or administration of, or attempted provision or administration of,
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insurance coverage for gender-affirming healthcare services or reproductive healthcare services to
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a beneficiary or a dependent of a beneficiary by any insurer, payor, or employer.
; or
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(iii) The prescription or administration, dispensing, or provision of, or attempted
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administration, dispensing, or provision of, a vaccination pursuant to the routine childhood and
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adult immunization vaccine recommendations that are developed under § 23-1-44; or
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(iii)
(iv)
“Aiding and assisting legally protected healthcare activity” does not include any
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conduct that violates Rhode Island law or deviates from the applicable standard of care or that could
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form the basis of a civil, criminal, or administrative action under the laws of this state had the
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course of conduct that forms the basis for liability occurred entirely within this state.
LC004819/SUB A/2 - Page 2 of 8
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(3) “Foreign judgment” means any judgment or decree of a court of another state.
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(4) “Gender-affirming healthcare services” means all supplies, care, and services of a
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medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive,
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rehabilitative, or supportive nature, including medication, relating to the treatment of gender
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dysphoria and gender incongruence in accordance with the accepted standard of care as defined by
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major medical professional organizations and agencies with expertise in the field of gender-
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affirming health care, including the Standards of Care for the Health of Transgender and Gender
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Diverse People, Version 8, or subsequent version, published by the World Professional Association
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for Transgender Health. “Gender-affirming healthcare services” does not include conversion
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therapy as defined by § 23-94-2.
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(5) “Healthcare provider” means and shall apply to the following:
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(i) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5;
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(ii) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5;
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(iii) A qualified physician assistant licensed pursuant to chapter 54 of title 5;
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(iv) A genetic counselor licensed pursuant to chapter 92 of title 5;
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(v) A qualified psychologist licensed pursuant to chapter 44 of title 5;
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(vi) A qualified social worker licensed pursuant to chapter 39.1 of title 5;
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(vii) An advanced practice registered nurse, and a certified nurse practitioner, licensed
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pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to
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chapters 34 and 34.2 of title 5;
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(viii) A certified nurse midwife licensed pursuant to chapter 13 of this title;
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(ix) A licensed clinical mental health counselor or associate, and a licensed marriage and
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family therapist or associate, licensed pursuant to chapter 63.2 of title 5;
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(x) An electrologist licensed pursuant to chapter 32 of title 5;
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(xi) A speech-language pathologist licensed pursuant to chapter 48 of title 5;
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(xii) An occupational therapist licensed pursuant to chapter 40.1 of title 5;
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(xiii) A chiropractic physician licensed pursuant to chapter 30 of title 5; and
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(xiv) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter
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19.1 of title 5.
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(6) “Hostile litigation” means any litigation or other legal action, including civil, criminal,
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or administrative action, to deter, prevent, sanction, or punish any person engaging in legally
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protected healthcare activity or aiding and assisting legally protected healthcare activity by:
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(i) Filing or prosecuting any litigation or other legal action in any other state where liability
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is based on legally protected healthcare activity or aiding and assisting legally protected healthcare
LC004819/SUB A/2 - Page 3 of 8
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activity that occurred in this state, including any action in which liability is based on any theory of
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vicarious, joint, or several liability; or
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(ii) Attempting to enforce any order or judgment issued in connection with any litigation
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or other legal action under subsection (6)(i) of this section by any party to the action or by any
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person acting on behalf of any party to the action.
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(iii) For purposes of this chapter, litigation or other legal action is based on legally protected
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healthcare activity or aiding and assisting legally protected healthcare activity that occurred in this
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state if any part of any act or omission involved in the course of conduct that forms the basis for
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liability in the action occurs or is initiated in this state, whether or not the act or omission is alleged
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or included in any pleading or other filing in the lawsuit.
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(7) “Law enforcement agency” means any police department in any city or town or the
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state police as defined in the general laws. For purposes of this act, a law enforcement agency may
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include any other non-federal entity in the state charged with the enforcement of laws relating to
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the custody of detained persons.
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(8) “Legally protected healthcare activity” means:
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(i) The exercise and enjoyment or attempted exercise and enjoyment by any person of the
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right secured by this state to gender-affirming healthcare services or reproductive healthcare
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services;
and
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(ii) The provision or attempted provision of gender-affirming healthcare services or
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reproductive healthcare services that are permitted under the laws and regulations of this state and
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that are provided in accordance with the applicable standard of care by a person properly licensed
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under the laws of this state and physically present in this state, regardless of whether the patient is
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located in this state or whether the person is licensed in the state where the patient is located at the
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time the services are rendered
.
; and
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(iii) The provision or attempted provision of a routine childhood or adult immunization
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vaccine under § 23-1-44.
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(iii)
(iv)
“Legally protected healthcare activity” does not include any conduct that could
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form the basis of a civil, criminal, or administrative action under the laws of this state had the
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course of conduct that forms the basis for liability occurred entirely within this state and/or in
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violation of Rhode Island law.
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(9) “Reproductive healthcare services” means all supplies, care, and services of a medical,
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behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive,
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rehabilitative, or supportive nature, including medication, relating to pregnancy, contraception,
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assisted reproduction, pregnancy loss management, or the termination of a pregnancy in accordance
LC004819/SUB A/2 - Page 4 of 8
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with the applicable standard of care as defined by major medical professional organizations and
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agencies with expertise in the field of reproductive health care.
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(10) "Routine childhood and adult immunization vaccine recommendations" means
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vaccine recommendations as determined by the director of the department of health to be necessary
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to protect the public health under § 23-1-44.
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(10)
(11)
“State” means a state of the United States, the District of Columbia, Puerto Rico,
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the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of
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the United States. The term “this state” refers to the state of Rhode Island.
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SECTION 3. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance
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Policies" is hereby amended by adding thereto the following section:
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27-18-96. Coverage for vaccinations.
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Every individual or group medical service contract or every individual or group hospital or
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medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
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on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
15
recommended by the Rhode Island department of health (RIDOH).
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SECTION 4. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
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Corporations" is hereby amended by adding thereto the following section:
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27-19-88. Coverage for vaccinations.
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Every individual or group medical service contract or every individual or group hospital or
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medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
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on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
22
recommended by the Rhode Island department of health (RIDOH).
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SECTION 5. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
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Corporations" is hereby amended by adding thereto the following section:
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27-20-84. Coverage for vaccinations.
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Every individual or group medical service contract or every individual or group hospital or
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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).
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SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance
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Organizations" is hereby amended by adding thereto the following section:
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27-41-101. Coverage for vaccinations.
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Every individual or group medical service contract or every individual or group hospital or
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medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state
LC004819/SUB A/2 - Page 5 of 8
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on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations
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recommended by the Rhode Island department of health (RIDOH).
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SECTION 7. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby
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amended by adding thereto the following section:
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40-8-33. Coverage for vaccinations.
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Commencing January 1, 2027, the medical assistance program shall provide coverage,
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without cost-sharing, for all vaccinations recommended by the Rhode Island department of health
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(RIDOH). This recommendation shall apply to all Medicaid beneficiaries, whether enrolled in fee-
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for-service or managed care, to the extent permitted under federal law.
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SECTION 8. Chapter 40-8.5 of the General Laws entitled "Health Care for Elderly and
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Disabled Residents Act" is hereby amended by adding thereto the following section:
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40-8.5-1.2. Coverage for vaccinations.
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(a) As used herein, "managed care systems" is defined as systems that: integrate an efficient
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financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate
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care and deter unnecessary services; and place emphasis on preventive and primary care. For
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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
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established by the executive office and serve the purposes of this section. Managed care systems
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may also include services and supports that optimize the health and independence of beneficiaries
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who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title (“long-
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term care service reform for Medicaid eligible individuals”) or to be at risk for the care under the
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applicable federal state plan or waiver authorities and the rules and regulations promulgated by the
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executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance
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may be provided such services through an entity certified by, or in a contractual arrangement with,
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the executive office or, as deemed appropriate, exempt from mandatory managed care in
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accordance with rules and regulations promulgated by the executive office.
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(b) Commencing January 1, 2027, any Medicaid managed care organizations under
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contract with the executive office of health and human services shall provide coverage, without
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cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH),
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to the extent permitted under federal law.
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SECTION 9. Chapter 36-12 of the General Laws entitled "Insurance Benefits" is hereby
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amended by adding thereto the following section:
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36-12-2.1.1. Coverage for vaccinations.
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Commencing January 1, 2027, the director of administration shall administer health benefit
LC004819/SUB A/2 - Page 6 of 8
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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 10. Severability.
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If any section of this act or its application to any person or circumstance is held invalid, the
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invalidity shall not affect other sections or applications of the act that can be given effect without
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the invalid section or application, and to this end the sections of this act are declared severable.
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SECTION 11. This act shall take effect upon passage.
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LC004819/SUB A/2
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HEALTH AND SAFETY -- DEPARTMENT OF HEALTH
***
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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
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of health and would mandate the coverage for the medical assistance program and managed care
4
organizations.
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This act would take effect upon passage.
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