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H7942 • 2026

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.)

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

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill 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.)

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.)

What This Bill Does

  • 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.)

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-03-24 Committee

    Committee recommended measure be held for further study

  2. 2026-03-20 Rhode Island General Assembly

    Scheduled for hearing and/or consideration (03/24/2026)

  3. 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
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LC003359
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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.
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LC003359
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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.
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LC003359
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