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Rhode Island · Through site files published 2025-08-13 · Newer source version available

R.I. Gen. Laws § 27-18.9-1: Purpose of chapter.

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Where this section sits in the code
  1. Title 27 Insurance
  2. Chapter 18.9 Benefit Determination and Utilization Review Act

(a) The purpose of this chapter is to:

(1) Promote the delivery of quality health care in a cost-effective manner;

(2) Foster greater coordination between healthcare providers, patients, healthcare entities, health benefit plans, and utilization review entities to ensure public health well-being;

(3) Protect beneficiaries, businesses, and providers by ensuring that review agents are qualified to perform review activities and to make informed decisions on the medical necessity and appropriateness of medical care;

(4) Ensure that review agents maintain the confidentiality of medical records in accordance with applicable state and federal laws; and

(5) Interface and maintain compliance with federal benefit determination and adverse benefit determination requirements.

(b) Nothing in this chapter is intended to prohibit or discourage the health insurance commissioner from consulting or collaborating with the department of health, or any other state or federal agency, to the extent the commissioner in the commissioner’s discretion determines such consultation and/or collaboration is necessary and/or appropriate for the administration and enforcement of this chapter.

Collected 2026-09-05T19:57:32Z. Source file · JSON

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