RI bills aimed at improving treatment coverage

By Danielle Ray
July 1st, 2024
Sen. Linda Ujifusa (D-11th District)
Sen. Linda Ujifusa (D-11th District)

Focus is on lack of parity, prior authorization denials

Two Rhode Island lawmakers have proposed legislation aimed at improving mental health and substance abuse treatment coverage.

Sen. Linda Ujifusa (D-11th District) and Rep. Teresa Tanzi (D-34th District) are behind the two bills that address lack of parity between mental and physical health care insurance coverage and denial of prior authorizations by insurers.

“I was inspired to get involved because one of my top legislative priorities is to make sure that health insurance company middlemen are not allowed to limit medically necessary care” --Sen. Linda Ujifusa (D-11th District)

“There is no question that since COVID, mental health and substance abuse problems have been increasing among people of all ages and demographics,” Ujifusa stated in a press release. “If we don’t address these problems today, we’ll face more serious and expensive problems later.”

The first bill (2024-S 2612, 2024-H 7876) would specify the insurance coverage standards, protocols, and guidelines for treatment of individuals with mental health or substance abuse use disorders.

It is based on a model parity bill developed by The Kennedy Forum in partnership with the American Psychiatric Association and more than 30 additional national organizations. So far, four states have adopted the legislation in full – California, Illinois, Georgia, and Oregon.

The second bill (2024-S 2393, 2024-H 7624) would prevent insurers from requiring that patients obtain prior authorization before seeking in-network mental health or substance use disorder health care.

Blue Cross Blue Shield of Rhode Island (BCBSRI) proactively dropped its preauthorization for such services in 2018, and the sponsors introduced the bill to require other insurers to follow suit.

Rep. Teresa Tanzi (D-34th District)

“BCBSRI has had this policy for years and likely saved money because it was not blocking early access to behavioral health care,” according to Tanzi. “There is no evidence that other insurance companies would face hardships in complying.”

She noted the bill is supported by the Office of the Health Insurance Commissioner, the Department of Behavioral Health and Developmental Disabilities and Hospitals, as well as MHARI, RIPIN, Lifespan, Newport Mental Health, and behavioral healthcare providers.

Ujifusa is the lead sponsor of both bills on the Senate side and Tanzi is the lead sponsor of both bills on the House side.

“I was inspired to get involved because one of my top legislative priorities is to make sure that health insurance company middlemen are not allowed to limit medically necessary care,” Ujifusa said.

There has not been a Senate hearing on either bill but there was a House Health and Human Services (HHS) Committee hearing on March 19 on both bills. The bills have been held for further study by the House HHS and are expected to be heard in the Senate HHS in the near future.

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