WeVote
Log In

Bill

Bill

SB 2806

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES -- EQUAL PAY FOR HEALTHCARE PROVIDERS

2026 Regular Session Introduced by Alana DiMario and 9 co-sponsors

Rhode Island requires equal reimbursement for nurse practitioners and physician assistants and physicians for the same services within their scope, across private and public insura

05/05/2026 Committee recommended measure be held for further study
0
WeVote Research Nonpartisan
Bill Summary · SB 2806

Bill Summary – SB 2806 (Rhode Island, 2026)

Title

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES -- EQUAL PAY FOR HEALTHCARE PROVIDERS

Purpose and Intent

This bill requires health insurers (including nonprofit hospital service corporations, medical service corporations, and other private insurers) and public programs to reimburse nurse practitioners (NPs) and physician assistants (PAs) at the same rate as physicians for the same medical services, when those services are within the lawful scope of practice of the NP/PA. The aim is to achieve equal pay for healthcare providers who independently deliver services that are billed under their own names and identifiers.

Key Provisions

Section 1: Equal pay in Accident and Sickness Insurance Policies (Private Insurers)

  • Applies to reimbursements for services within the NP/PA scope of practice, including prescribing or dispensing drugs, and primary care or mental health services.
  • If the service is provided by an NP/PA (or other licensed professionals defined in the statute) but performed under the supervision or collaboration of a physician, the insured is entitled to reimbursement equal to what a physician would receive for the same service, in the same area.
  • Independent practice defined: NP/PA bills insurers for services using their own name and National Provider Identifier (NPI), with diagnoses and procedures coded accordingly.
  • Exclusions: Does not apply to certain group practice HMOs federally qualified under Title XIII, or insurers that employ physicians, PAs, or NPs for primary/mental health care and compensate on a non-fee-for-service basis.
  • Protection for physicians: Insurers may not reduce physician reimbursement to meet this equal-pay standard.

Section 2: Equal pay in Nonprofit Hospital Service Corporations (Rs 27-19)

  • Mirrors Section 1 for nonprofit hospital service corporations.
  • Uses the same definitions, independent practice, exclusions, and prohibitions on reducing physician payments.

Section 3: Equal pay in Nonprofit Medical Service Corporations (Rs 27-20)

  • Mirrors Section 1 for nonprofit medical service corporations.
  • Uses the same framework and protections.

Section 4: Equal pay in Medical Assistance (Public program – EOHH)

  • Beginning January 1, 2027, EOHHS (Executive Office of Health and Human Services) must reimburse NP/PA services at the same rate as physicians for eligible services.
  • Requires EOHHS to pursue any necessary amendments to the state Medicaid plan or waivers to implement this provision.
  • Medicaid state plan amendment due by October 1, 2026.

Section 5: Effective Date

  • The act takes effect January 1, 2027.

Affected Parties

  • Authorized nurse practitioners and physician assistants:
    • Eligible for equal reimbursement to physicians when providing services within their scope of practice, including primary care and mental health.
    • Independent practice NPs/PAs billing under their own name/NPI are specifically covered.
  • Physicians:
    • Protected from reimbursement reductions to align with equal-pay requirements.
  • Private insurers and government programs:
    • Rhode Island’s regulatory framework will require parity in reimbursement rates for NP/PA-provided services.
  • Exclusions:
    • Federally qualified HMOs operating under Title XIII that employ physicians/PAs/NPs on a non-fee-for-service basis.
    • Insurers who do not compensate such providers on a fee-for-service basis.

Procedural and Timeline Aspects

  • Introduction and referral: Introduced March 4, 2026; referred to Senate Finance.
  • Hearing schedule: Set for consideration around May 1, 2026.
  • Medicaid implementation timeline:
    • Medicaid state plan amendments needed; submission target by October 1, 2026.
    • Full implementation for Medicaid begins January 1, 2027.
  • General effective date: January 1, 2027.

Summary of Impact

  • The bill seeks to ensure equitable reimbursement for NP/PA-delivered care relative to physicians for the same services, wherever the service is within the providers' lawful scope.
  • Aims to improve access to care by recognizing the contributions of NPs and PAs and reducing financial barriers to their independent practice.
  • Could influence insurer reimbursement practices, provider enrollment, and coordination between physician and NP/PA services in Rhode Island.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.