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S2032
2026 -- S 2032
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LC003440
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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 INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By:
Senators Zurier, Sosnowski, Murray, Tikoian, Urso, Lauria, Thompson,
Valverde, Ujifusa, and Appollonio
Date Introduced:
January 09, 2026
Referred To:
Senate Health & Human Services
It is enacted by the General Assembly as follows:
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SECTION 1. 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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27-18-42.1. Diagnostic and supplemental breast examination.
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(a) As used in this section, the following words shall have the following meanings:
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(1) "Cost-sharing requirements" means a deductible, coinsurance, copayment and any
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maximum limitation on the application of such a deductible, coinsurance, copayment or similar
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out-of-pocket expense.
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(2) "Diagnostic breast examinations" means a medically necessary and appropriate
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examination of the breast, including an examination using diagnostic mammography, breast
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magnetic resonance imaging, or breast ultrasound, that is:
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(i) Used to evaluate an abnormality seen or suspected from a screening examination for
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breast cancer; or
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(ii) Used to evaluate an abnormality detected by another means of examination.
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(3) "Supplemental breast examinations" means a medically necessary and appropriate
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examination of the breast, including an examination using breast magnetic resonance imaging, or
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breast ultrasound, that is:
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(i) Used to screen for breast cancer when there is no abnormality seen or suspected; and
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(ii) Based on personal or family medical history, or additional factors that may increase the
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individual’s risk of breast cancer.
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(b) In the case that a group health plan, or a health insurance issuer offering group or
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individual health insurance coverage, that provides benefits with respect to screening, supplemental
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and diagnostic breast examinations furnished to an individual enrolled under such plan or such
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coverage, the plan or coverage shall not impose any cost-sharing requirements.
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SECTION 2. 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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27-19-34.2. Diagnostic and supplemental breast examination.
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(a) As used in this section, the following words shall have the following meanings:
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(1) "Cost-sharing requirements" means a deductible, coinsurance, copayment and any
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maximum limitation on the application of such a deductible, coinsurance, copayment or similar
11
out-of-pocket expense.
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(2) "Diagnostic breast examinations" means a medically necessary and appropriate
13
examination of the breast, including an examination using diagnostic mammography, breast
14
magnetic resonance imaging, or breast ultrasound, that is:
15
(i) Used to evaluate an abnormality seen or suspected from a screening examination for
16
breast cancer; or
17
(ii) Used to evaluate an abnormality detected by another means of examination.
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(3) "Supplemental breast examinations" means a medically necessary and appropriate
19
examination of the breast, including an examination using breast magnetic resonance imaging, or
20
breast ultrasound, that is:
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(i) Used to screen for breast cancer when there is no abnormality seen or suspected; and
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(ii) Based on personal or family medical history, or additional factors that may increase the
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individual’s risk of breast cancer.
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(b) In the case that a group health plan, or a health insurance issuer offering group or
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individual health insurance coverage, that provides benefits with respect to screening, supplemental
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and diagnostic breast examinations furnished to an individual enrolled under such plan or such
27
coverage, the plan or coverage shall not impose any cost-sharing requirements.
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SECTION 3. 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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27-20-17.2. Diagnostic and supplemental breast examination.
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(a) As used in this section, the following words shall have the following meanings:
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(1) "Cost-sharing requirements" means a deductible, coinsurance, copayment and any
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maximum limitation on the application of such a deductible, coinsurance, copayment or similar
34
out-of-pocket expense.
LC003440 - Page 2 of 5
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(2) "Diagnostic breast examinations" means a medically necessary and appropriate
2
examination of the breast, including an examination using diagnostic mammography, breast
3
magnetic resonance imaging, or breast ultrasound, that is:
4
(i) Used to evaluate an abnormality seen or suspected from a screening examination for
5
breast cancer; or
6
(ii) Used to evaluate an abnormality detected by another means of examination.
7
(3) "Supplemental breast examinations" means a medically necessary and appropriate
8
examination of the breast, including an examination using breast magnetic resonance imaging, or
9
breast ultrasound, that is:
10
(i) Used to screen for breast cancer when there is no abnormality seen or suspected; and
11
(ii) Based on personal or family medical history, or additional factors that may increase the
12
individual’s risk of breast cancer.
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(b) In the case that a group health plan, or a health insurance issuer offering group or
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individual health insurance coverage, that provides benefits with respect to screening, supplemental
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and diagnostic breast examinations furnished to an individual enrolled under such plan or such
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coverage, the plan or coverage shall not impose any cost-sharing requirements.
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SECTION 4. 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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27-41-30.2. Diagnostic and supplemental breast examination.
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(a) As used in this section, the following words shall have the following meanings:
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(1) "Cost-sharing requirements" means a deductible, coinsurance, copayment and any
22
maximum limitation on the application of such a deductible, coinsurance, copayment or similar
23
out-of-pocket expense.
24
(2) "Diagnostic breast examinations" means a medically necessary and appropriate
25
examination of the breast, including an examination using diagnostic mammography, breast
26
magnetic resonance imaging, or breast ultrasound, that is:
27
(i) Used to evaluate an abnormality seen or suspected from a screening examination for
28
breast cancer; or
29
(ii) Used to evaluate an abnormality detected by another means of examination.
30
(3) "Supplemental breast examinations" means a medically necessary and appropriate
31
examination of the breast, including an examination using breast magnetic resonance imaging, or
32
breast ultrasound, that is:
33
(i) Used to screen for breast cancer when there is no abnormality seen or suspected; and
34
(ii) Based on personal or family medical history, or additional factors that may increase the
LC003440 - Page 3 of 5
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individual’s risk of breast cancer.
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(b) In the case that a group health plan, or a health insurance issuer offering group or
3
individual health insurance coverage, that provides benefits with respect to screening, supplemental
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and diagnostic breast examinations furnished to an individual enrolled under such plan or such
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coverage, the plan or coverage shall not impose any cost-sharing requirements.
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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
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This act would prohibit an insurance company from imposing any cost-sharing
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requirements for any diagnostic or supplemental breast examinations.
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This act would take effect on January 1, 2027.
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