Rhode Island General Laws Title 27. Insurance § 27-18.9-16. Prior authorization reduction and improvement

(a) The purpose of this chapter is to authorize a three-year (3) pilot program whereby, except as provided in subsection (b), an insurer shall not impose a prior authorization requirement for any admission, item, service, treatment, or procedure ordered by a primary care provider in the normal course of providing primary care treatment.

(b) The prohibition set forth in subsection (a) shall not be construed to prohibit prior authorization requirements for prescription drugs.

(c) Nothing in this section shall be construed to modify the rights or obligations of an insurer or provider with respect to procedures relating to the investigation, audit, reporting, or appeal, under applicable law of potentially fraudulent billing activities, waste or abuse.

(d) Annually on or before July 1, each insurer shall submit to the office of the governor, the speaker of the house of representatives, the president of the senate, and the office of the health insurance commissioner a written report in compliance with the rules and regulations to be promulgated by the office of the health insurance commissioner on or before January 1, 2026.

(e) Unless an act of the general assembly expressly authorizes the continuation of the program, the provisions of this chapter shall sunset and expire on October 1, 2028.