Rhode Island 2026 Regular Session

Rhode Island House Bill H7941

Introduced
2/27/26  

Caption

Requires insurers to pay electronic claims for healthcare coverage within 14 calendar days of receipt. Permits healthcare providers to dispute claim denials within 60 days and empowers the secretary of EOHHS to establish penalties for violations.

Impact

The enactment of H7941 significantly reforms the claims processing landscape within the state. It seeks to enhance the efficiency with which healthcare providers are reimbursed for services rendered, promoting faster access to funds necessary for continuing operations. The bill's stipulation that penalties can be imposed on those failing to comply with these new requirements adds a layer of accountability, that advocates believe will deter malpractice among healthcare payers. As a result, this legislation could reduce the financial strain on healthcare providers, fostering a more stable healthcare environment.

Summary

House Bill H7941 mandates that healthcare entities and health plans in Rhode Island must process and pay all electronic claims for healthcare coverage within fourteen calendar days of receipt. It emphasizes the establishment of a written standard by each health plan to define what constitutes a complete claim. Additionally, the bill permits healthcare providers and policyholders to dispute any claim denials within a stipulated period of sixty days, creating a more accountable claims process in the healthcare sector.

Contention

Despite its intended benefits, H7941 may face opposition from certain sectors within the insurance industry that argue the bill imposes undue regulatory burdens. Detractors may express concerns regarding the feasibility of meeting the stringent timelines set for claims processing, particularly for smaller healthcare entities that might struggle with rapid technological adoption. The overall debate here centers around balancing the need for prompt payment to healthcare providers against the operational capacities of health insurers.

Companion Bills

No companion bills found.

Previously Filed As

RI S0052

Prohibits certain claim practices of health insurers and medical providers. The act would further require fulfillment of medical record requests within fourteen (14) days.

RI H5066

Prohibits certain claim practices of health insurers and medical providers. The act would further require fulfillment of medical record requests within fourteen (14) days.

RI S0846

Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.

RI H5561

Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.

RI S0463

Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.

RI H5863

Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.

RI S0905

Prohibits dental insurers from refusing to honor directions to pay from insured, modifying benefits to be paid. Requires providers to accept payment by virtual credit card as unfair claims practices.

RI H6155

Prohibits dental insurers from refusing to honor directions to pay from insured, modifying benefits to be paid. Requires providers to accept payment by virtual credit card as unfair claims practices.

RI S0305

Establishes the right of a medical practitioner, healthcare institution, or healthcare payer not to participate in or pay for any medical procedure or service this violates their conscience.

RI H5426

Requires the disclosure of the transfer of certain assets of healthcare facilities and provides penalties for failing to file healthcare facility ownership information.

Similar Bills

LA HB1121

Authorizes certain healthcare entities to refuse to provide healthcare services under certain circumstances

RI H7030

Creates the healthcare worker platform act that requires platforms offering healthcare shifts to register with the Rhode Island department of health while exempting them from being classified as nursing service agencies.

AR HB1299

To Prohibit Healthcare Insurers From Exercising Recoupment For Payment Of Healthcare Services More Than One Year After The Payment For Healthcare Services Was Made.

AR HB1301

To Amend The Prior Authorization Transparency Act.

RI H8310

Amends the timelines related to healthcare provider credentialing.

MA S1632

Providing safeguards for home healthcare workers

MA H2364

Providing safeguards for home healthcare workers

RI H7002

Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.