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Rhode IslandH51202025 Regular SessionHouseWALLET

AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT .

Sponsored By: Brandon C. Potter (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Fewer insurance approval barriers for patients

Beginning July 1, 2026, Rhode Island insurers cannot require prior approval for care ordered by an in-network primary care provider. This covers hospital admissions, items, services, treatments, and procedures, but excludes prescription drugs. The Office of the Health Insurance Commissioner must also ensure insurers minimize paperwork and other administrative burdens that delay medically necessary care. It can use rules and enforcement actions to do this.

Sponsors & Cosponsors

Sponsor

  • Brandon C. Potter

    Democratic • House

Cosponsors

  • David A. Bennett

    Democratic • House

  • Justine A. Caldwell

    Democratic • House

  • Susan R. Donovan

    Democratic • House

  • Kathleen A. Fogarty

    Democratic • House

  • Joshua J. Giraldo

    Democratic • House

  • Arthur Handy

    Democratic • House

  • Rebecca M. Kislak

    Democratic • House

  • Michelle E. McGaw

    Democratic • House

  • David Morales

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 109 • No: 0

Senate vote • 6/20/2025

INSURANCE--BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT In Concurrence Passage

Yes: 36 • No: 0

House vote • 6/16/2025

INSURANCE--BENEFIT/REVIEW ACT PASSAGE

Yes: 73 • No: 0

Actions Timeline

  1. Signed by Governor — Chapter 436

    7/2/2025Governor

  2. Transmitted to Governor

    6/27/2025Governor

  3. Senate passed Sub A in concurrence

    6/20/2025Senate

  4. Placed on Senate Calendar (06/20/2025)

    6/18/2025Senate

  5. House passed Sub A

    6/16/2025House

  6. Placed on House Calendar (06/16/2025)

    6/13/2025House

  7. Committee recommends passage of Sub A

    6/12/2025

  8. Proposed Substitute

    6/9/2025

  9. Scheduled for consideration (06/12/2025)

    6/9/2025

  10. Committee recommended measure be held for further study

    4/23/2025

  11. Scheduled for hearing and/or consideration (04/23/2025)

    4/18/2025

  12. Committee postponed at request of sponsor (04/01/2025)

    3/31/2025

  13. Scheduled for hearing and/or consideration

    3/28/2025

  14. Introduced, referred to House Health & Human Services

    1/22/2025House

Bill Text

  • H5120 - As Introduced

    1/22/2025

    HTMLPDF

  • H5120 - Substitute

    1/22/2025

    HTMLPDF

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