AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT (Requires insurance companies to prove that a healthcare service or procedure is not medically necessary.)

Healthcare

Passed Legislature

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

Sponsor: Solomon
Last action: 2026-03-24
Official status: Committee recommended measure be held for further study
Effective date: Not listed

Plain English Breakdown

The plain English breakdown is still being put together. The official documents below are already here.

Bill History

2026-03-24 Committee
Committee recommended measure be held for further study
2026-03-20 Rhode Island General Assembly
Scheduled for hearing and/or consideration (03/24/2026)
2026-02-27 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 (Requires insurance companies to prove that a healthcare service or procedure is not medically necessary.)

Current Bill Text

Read the full stored bill text

H7942

2026 -- H 7942
========
LC003359
========

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:
Representative Joseph J. Solomon

Date Introduced:
February 27, 2026

Referred To:
House Health & Human Services
It is enacted by the General Assembly as follows:
1
SECTION 1. Chapter 27-18.9 of the General Laws entitled "Benefit Determination and
2
Utilization Review Act" is hereby amended by adding thereto the following section:
3

27-18.9-17. Medically necessary treatment -- Justification for denial.

4

Any healthcare service or procedure authorized by a provider to a patient shall create a
5
presumption that the healthcare service or procedure is medically necessary and it shall be the duty
6
of the insurance company to provide justification for any denial of such healthcare service or
7
procedure.
8
SECTION 2. This act shall take effect upon passage.
========
LC003359
========

EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION
REVIEW ACT
***
1
This act would require insurance companies to prove that a healthcare service or procedure
2
is not medically necessary.
3
This act would take effect upon passage.
========
LC003359
========

LC003359 - Page 2 of 2