§ 42-14.5-1.1 - Legislative findings. - Rhode Island Statutes

SECTION 42-14.5-1.1

   § 42-14.5-1.1  Legislative findings. –The general assembly hereby finds and declares as follows:

   (1) A substantial amount of health care services in thisstate are purchased for the benefit of patients by health care insurers engagedin the provision of health care financing services or is otherwise deliveredsubject to the terms of agreements between health care insurers and providersof the services.

   (2) Health care insurers are able to control the flow ofpatients to providers of health care services through compelling financialincentives for patients in their plans to utilize only the services ofproviders with whom the insurers have contracted.

   (3) Health care insurers also control the health careservices rendered to patients through utilization review programs and othermanaged care tools and associated coverage and payment policies.

   (4) By incorporation or merger the power of health careinsurers in markets of this state for health care services has become greatenough to create a competitive imbalance, reducing levels of competition andthreatening the availability of high quality, cost-effective health care.

   (5) The power of health care insurers to unilaterally imposeprovider contract terms may jeopardize the ability of physicians and otherhealth care providers to deliver the superior quality health care services thathave been traditionally available in this state.

   (6) It is the intention of the general assembly to authorizehealth care providers to jointly discuss with health care insurers topics ofconcern regarding the provision of quality health care through a committeeestablished by an advisory to the health insurance commissioner.