R.I. Gen. Laws § 42-14.6-3

Current through 2024 Public Law 457

Section 42-14.6-3 - Definitions

As used in this section, the following terms shall have the following meanings:

(1) "Commissioner" means the health insurance commissioner.

(2) "Health insurer" means all entities licensed, or required to be licensed, in this state that offer health benefit plans in Rhode Island including, but not limited to, nonprofit hospital service corporations and nonprofit medical-service corporations established pursuant to chapters 19 and 20 of title 27, and health maintenance organizations established pursuant to chapter 41 of title 27 or as defined in chapter 62 of this title, a fraternal benefit society or any other entity subject to state insurance regulation that provides medical care on the basis of a periodic premium, paid directly or through an association, trust or other intermediary, and issued, renewed, or delivered within or without Rhode Island.

(3) "Health insurance plan" means any individual, general, blanket or group policy of health, accident and sickness insurance issued by a health insurer (as herein defined). Health Insurance Plan shall not include insurance coverage providing benefits for:

(i) Hospital confinement indemnity;

(ii) Disability income;

(iii) Accident only;

(iv) Long-term care;

(v) Medicare supplement;

(vi) Limited benefit health;

(vii) Specified disease indemnity;

(viii) Sickness or bodily injury or death by accident or both; and

(ix) Other limited benefit policies.

(4) "Personal clinician" means a physician, physician assistant, or an advanced practice nurse licensed by the department of health.

(5) "State healthcare program" means medical assistance, RIteCare, and any other health insurance program provided through the office of health and human services (OHHS) and its component state agencies state healthcare program does not include any health insurance plan provided as a benefit to state employees or retirees.

(6) "Patient-centered medical home" means a practice that satisfies the characteristics described in § 42-14.6-2, and is designated as such by the secretary, or through alternative models as provided for in § 42-14.6-7, based on standards recommended by the patient-centered medical home collaborative.

(7) "Patient-centered medical home collaborative" means a community advisory council, including, but not limited to, participants in the existing Rhode Island patient-centered medical home pilot project, and health insurers, physicians and other clinicians, employers, the state healthcare program, relevant state agencies, community health centers, hospitals, other providers, patients, and patient advocates which shall provide consultation and recommendations to the secretary and the commissioner on all matters relating to proposed regulations, development of standards, and development of payment mechanisms.

(8) "Secretary" means the secretary of the executive office of health and human services.

R.I. Gen. Laws § 42-14.6-3

P.L. 2011, ch. 260, § 1.