AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES -- EQUAL PAY FOR HEALTHCARE PROVIDERS (Requires the state and private health insurers to reimburse claims for healthcare services provided by nurse practitioners and physician assistants at the same amount as the reimbursement paid to a physician performing the service in the area served.)

H8135

2026 -- H 8135
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LC005473
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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 --
EQUAL PAY FOR HEALTHCARE PROVIDERS

Introduced By:
Representatives Casimiro, Donovan, Spears, Potter, Alzate, Shallcross
Smith, and Hopkins

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 of the General Laws entitled "Accident and Sickness Insurance
2
Policies" is hereby amended by adding thereto the following section:
3

27-18-96. Equal pay for healthcare providers.

4

(a) Whenever any policy of health insurance provides for reimbursement for any service
5
which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
6
defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
7
service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
8
for such service, whether it is performed by a physician licensed by the board of medical licensure
9
and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
10
as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
11
professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
12
physician assistant or nurse practitioner.
13

(b) The reimbursement of a service described in subsection (a) of this section that is
14
provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
15
practice shall be in the same amount as the reimbursement paid under the policy to a licensed
16
physician performing the service in the area served.
17

(c) As used in this section, “independent practice” means the provision of healthcare
18
services to patients in a setting in which the licensed physician assistant or the certified nurse

1
practitioner bills insurers for services identified by diagnosis and procedure codes using the
2
physician assistant’s or nurse practitioner’s own name and national provider identifier.
3

(d) This section does not apply to group practice health maintenance organizations that are
4
federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
5
insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
6
provide primary care or mental health services and do not compensate such practitioners on a fee
7
for-service basis.
8

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
9
comply with this section.
10
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
11
Corporations" is hereby amended by adding thereto the following section:
12

27-19-88. Equal pay for healthcare providers.

13

(a) Whenever any policy of health insurance provides for reimbursement for any service
14
which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
15
defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
16
service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
17
for such service, whether it is performed by a physician licensed by the board of medical licensure
18
and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
19
as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
20
professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
21
physician assistant or nurse practitioner.
22

(b) The reimbursement of a service described in subsection (a) of this section that is
23
provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
24
practice shall be in the same amount as the reimbursement paid under the policy to a licensed
25
physician performing the service in the area served.
26

(c) As used in this section, “independent practice” means the provision of healthcare
27
services to patients in a setting in which the licensed physician assistant or the certified nurse
28
practitioner bills insurers for services identified by diagnosis and procedure codes using the
29
physician assistant’s or nurse practitioner’s own name and national provider identifier.
30

(d) This section does not apply to group practice health maintenance organizations that are
31
federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
32
insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
33
provide primary care or mental health services and do not compensate such practitioners on a fee
34
for-service basis.

LC005473 - Page 2 of 5
1

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
2
comply with this section.
3
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
4
Corporations" is hereby amended by adding thereto the following section:
5

27-20-84. Equal pay for healthcare providers.

6

(a) Whenever any policy of health insurance provides for reimbursement for any service
7
which is within the lawful scope of practice of a duly licensed and certified nurse practitioner, as
8
defined in § 5-34-3, including prescribing or dispensing drugs, a primary care or mental health
9
service, provided by a licensed physician, the insured under the policy is entitled to reimbursement
10
for such service, whether it is performed by a physician licensed by the board of medical licensure
11
and discipline or by a duly licensed nurse practitioner, if provided by a licensed physician assistant,
12
as defined in chapter 54 of title 5 or a certified nurse practitioner, or other licensed healthcare
13
professionals, as defined in § 27-18-1.1, if the service is within the lawful scope of practice of the
14
physician assistant or nurse practitioner.
15

(b) The reimbursement of a service described in subsection (a) of this section that is
16
provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
17
practice shall be in the same amount as the reimbursement paid under the policy to a licensed
18
physician performing the service in the area served.
19

(c) As used in this section, “independent practice” means the provision of healthcare
20
services to patients in a setting in which the licensed physician assistant or the certified nurse
21
practitioner bills insurers for services identified by diagnosis and procedure codes using the
22
physician assistant’s or nurse practitioner’s own name and national provider identifier.
23

(d) This section does not apply to group practice health maintenance organizations that are
24
federally qualified pursuant to Title XIII of the Health Maintenance Organization Act, or other
25
insurers that employ physicians, licensed physician assistants or certified nurse practitioners to
26
provide primary care or mental health services and do not compensate such practitioners on a fee
27
for-service basis.
28

(e) An insurer may not reduce the reimbursement paid to a licensed physician in order to
29
comply with this section.
30
SECTION 4. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby
31
amended by adding thereto the following section:
32

40-8-33. Equal pay for healthcare providers.

33

(a) Beginning January 1, 2027, the executive office of health and human services (EOHHS)
34
shall provide for reimbursement for any service which is within the lawful scope of practice of a

LC005473 - Page 3 of 5
1
duly licensed and certified nurse practitioner, as defined in § 5-34-3, including prescribing or
2
dispensing drugs, a primary care or mental health service, provided by a licensed physician, the
3
insured under the policy is entitled to reimbursement for such service, whether it is performed by
4
a physician licensed by the board of medical licensure and discipline or by a duly licensed nurse
5
practitioner, if provided by a licensed physician assistant, as defined in chapter 54 of title 5 or a
6
certified nurse practitioner, or other licensed healthcare professionals, as defined in § 27-18-1.1, if
7
the service is within the lawful scope of practice of the physician assistant or nurse practitioner.
8

(b) The reimbursement of a service described in subsection (a) of this section that is
9
provided by a licensed physician assistant or a certified nurse practitioner who is in an independent
10
practice shall be in the same amount as the reimbursement paid under the policy to a licensed
11
physician performing the service in the area served.
12

(c) As used in this section, “independent practice” means the provision of healthcare
13
services to patients in a setting in which the licensed physician assistant or the certified nurse
14
practitioner bills insurers for services identified by diagnosis and procedure codes using the
15
physician assistant’s or nurse practitioner’s own name and national provider identifier.
16

(d) The secretary of the EOHHS shall apply to the United States department of health and
17
human services for any amendment to the state Medicaid plan or for any Medicaid waiver as
18
necessary to implement this section. The secretary of the EOHHS shall submit the Medicaid state
19
plan amendment on or before October 1, 2026.
20
SECTION 5. This act shall take effect on January 1, 2027.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --
EQUAL PAY FOR HEALTHCARE PROVIDERS
***
1
This act would require the state and private health insurers to reimburse claims for
2
healthcare services provided by nurse practitioners and physician assistants at the same amount as
3
the reimbursement paid to a physician performing the service in the area served.
4
This act would take effect on January 1, 2027.
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LC005473 - Page 5 of 5