{"data":{"id":"us-ri/r.i.-gen.-laws-27-20.10-6","jurisdiction":"us-ri","citation":"R.I. Gen. Laws § 27-20.10-6","heading":"Unauthorized access to provider network contracts.","body":"(a) It is an unfair insurance practice for the purposes of chapter 29 of this title to knowingly access or utilize a provider’s contractual discount pursuant to a provider network contract without a contractual relationship with the provider, contracting entity, or third party, as specified in this chapter.\n(b) Contracting entities and third parties are obligated to comply with § 27-20.10-4(b)(2) or § 27-20.10-5(c)(1) and (2) concerning the services referenced on a remittance advice (RA) or explanation of payment (EOP). A provider may refuse the discount taken on the RA or EOP if the discount is taken without a contractual basis or in violation of these sections. However, an error in the RA or EOP may be corrected within thirty (30) days following notice by the provider.\n(c) A contracting entity may not lease, rent, or otherwise grant to a third party, access to a provider network contract unless the third party accessing the healthcare contract is:\n(1) A payer or third-party administrator or another entity that administers or processes claims on behalf of the payer;\n(2) A preferred provider organization or preferred provider network, including a physician organization or physician-hospital organization; or\n(3) An entity engaged in the electronic claims transport between the contracting entity and the payer that does not provide access to the provider’s services and discount to any other third party.","path":["Title 27 Insurance","Chapter 20.10 Rental Network Contract Arrangements"],"source_url":"https://webserver.rilegislature.gov/Statutes/TITLE27/27-20.10/27-20.10-6.htm","current_through":"site files published 2025-08-13","vintage":"","retrieved_at":"2026-09-05T19:57:36Z","sha256":"bac1f30d5153c21c8ad4984d599b9620239af92a092265995d24d582c6a43b7d","source_id":"us-ri","stale":true,"prev":"us-ri/r.i.-gen.-laws-27-20.10-5","next":"us-ri/r.i.-gen.-laws-27-20.10-7"},"notice":"GroundRules: Original legal text. Not legal advice."}