Rhode Island law bars doctors from withholding insurance bills and health plans from rejecting them solely over another party’s involvement, except workers’ compensation claims.
Health plans cannot reject a medical bill solely because it may arise from a claim or incident involving someone else. Workers’ compensation claims are excluded.
Doctors commit unprofessional conduct if they withhold bills from health insurers solely because a claim or incident involving someone else may be involved. Workers’ compensation claims are excluded.
Health plans cannot deny payment solely because a medical bill may arise from a claim or incident involving someone else. The rule covers health insurers and health plans operating in Rhode Island, including nonprofit medical plans and health maintenance organizations. Workers’ compensation claims are excluded from this restriction. Other reasons for denying payment remain possible; this rule does not require payment of every medical bill. The law takes effect upon passage.
The law treats a doctor’s failure to submit these medical bills to a health insurer as unprofessional conduct. The rule concerns doctors governed by Rhode Island’s medical licensing law. The possible connection to a claim or incident involving someone else must be the only reason for not submitting the bill. Workers’ compensation claims are excluded. The law takes effect upon passage.
No hearings or votes scheduled.