27 R.I. Gen. Laws § 27-20-61. Medical loss ratio reporting and rebates: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted Year Enacted: 2012
Health insurance carriers required to report medical loss ratio and rebate calculations and other medical loss ratio and rebate information to the U.S. Department of Health and Human Services shall concurrently file such information with …
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27 R.I. Gen. Laws § 27-20-62. Emergency services: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this …
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27 R.I. Gen. Laws § 27-20-9. Examination of affairs of corporations: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted Year Enacted: 1945
It is the duty of the insurance commissioner to make an examination of the financial condition and methods of doing business of every nonprofit medical service corporation.
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27 R.I. Gen. Laws § 27-20.5-1. Restriction on participation prohibited: Participation of Medical Service Providers – Rhode Island
Status: Enacted Year Enacted: 1986
It shall be unlawful for any nonprofit medical service corporation, hospital service corporation, health maintenance organization, or any other insurer offering and/or insuring health services on a prepaid basis to require providers of medical services …
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27 R.I. Gen. Laws § 27-20.9-1. Health care contracts — Required provisions — Definitions: Contract with Health Care Providers – Rhode Island
Status: Enacted Year Enacted: 2007
Definitions related to Contract with Health Care Providers
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27 R.I. Gen. Laws § 27-20.9-2. Credentialing — Insurers shall notify providers of initial credentialing within ten business days of approval by the insurer credentialing committee: Contract with Health Care Providers – Rhode Island
Status: Enacted Year Enacted: 2007
The health insurer shall reimburse the health care provider for covered services rendered by the health care provider to the health insurer’s subscribers or members following the first business day after the credentialing committee’s approval, …
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27 R.I. Gen. Laws § 27-20.9-3. Pay-for-performance guidelines: Contract with Health Care Providers – Rhode Island
Status: Enacted Year Enacted: 2007
A health insurer shall not require a physician, as a condition of contracting, to participate in any financial or reimbursement incentive program, commonly referred to as pay-for-performance programs unless such program meets the principles and …
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27 R.I. Gen. Laws § 27-29-17.3. Notice of premium or coverage changes: Insurance – Unfair Competition and Practices – Rhode Island
Status: Enacted Year Enacted: 2003
An insurer shall provide to the first-named insured at the mailing address shown on the policy, and to the insurance producer of record, written notice of any premium increase in excess of ten percent (10%) …
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27 R.I. Gen. Laws § 27-29-6. Cease and desist orders and modifications of those orders: Insurance – Unfair Competition and Practices – Rhode Island
Status: Enacted Year Enacted: 1958
If after a hearing the insurance commissioner shall determine that the method of competition or the act or practice in question is unfair and that the person complained of has engaged in a method of …
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27 R.I. Gen. Laws § 27-29-8. Procedure as to unfair methods of competition and unfair or deceptive acts or practices which are not defined: Insurance – Unfair Competition and Practices – Rhode Island
Status: Enacted Year Enacted: 1958
Provides authority for the insurance commissioner and the court to enforce provisions under this chapter.
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27 R.I. Gen. Laws § 27-29-9. Penalty: Insurance – Unfair Competition and Practices – Rhode Island
Status: Enacted Year Enacted: 1958
Any person who violates a cease and desist order of the insurance commissioner under § 27-29-6 after it has become final, and while the order is in effect, shall, upon proof of the violation to …
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27 R.I. Gen. Laws § 27-35-5. Examination: Insurance Holding Company Systems – Rhode Island
Status: Enacted Year Enacted: 1971
The commissioner shall have the power to examine any insurer registered under 27-35-3 and its affiliates to ascertain the financial condition of the insurer, including the enterprise risk to the insurer by the ultimate controlling …
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27 R.I. Gen. Laws § 27-41-10. Information to enrollees: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1983
Every health maintenance organization shall promptly provide to its enrollees notice of any material change in the operation of the organization that will affect them directly.
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27 R.I. Gen. Laws § 27-41-14.1. Prohibition against restraint on provider-patient communications: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1997
No health maintenance organization shall refuse to contract with or compensate for covered services an otherwise eligible health care provider solely because the provider has in good faith communicated with one or more of his …
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27 R.I. Gen. Laws § 27-41-16. Examination: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1983
The director of health may make an examination concerning the quality of health care services of any health maintenance organization and the providers with whom the organization has contracts, agreements, or other arrangements as often …
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27 R.I. Gen. Laws § 27-41-2. Definitions: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1983
Provides defintions for Chapter 41 Health Maintenance Organizations.
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