loading…
loading…
loading…
(a) Every individual or group hospital or medical expense insurance policy or contract
providing coverage for dependent children, delivered or renewed in this state on or after July 1,
2004, shall include coverage of early intervention services which coverage shall take effect no later
than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)
per dependent child per policy or calendar year and shall not be subject to deductibles and
coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall
not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For
the purpose of this section, “early intervention services” means, but is not limited to: speech and
language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition,
service plan development and review, nursing services, and assistive technology services and
devices for :
(1) dependents Dependents from birth to age three (3) who are certified by the department
of executive office of health and human services (“EOHHS”) as eligible for services under part
Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.) ; or
(2) Dependents who are older than age three (3) and are eligible for services pursuant to §
23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals
with Disabilities Education Act (20 U.S.C. § 1431 et seq.) .
(b) Subject to the annual limits provided in this section, insurers shall reimburse certified
early intervention providers, who are designated as such by the department of human services
EOHHS , for early intervention services as defined in this section at rates of reimbursement equal
to or greater than the prevailing integrated state/Medicaid rate for early intervention services as
established by the department of human services EOHHS .
(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital
confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare
supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily
injury or death by accident or both; and (9) Other limited benefit policies.
SECTION 6. Sections 40-5.2-10, 40-5.2-20 and 40-5.2-35 of the General Laws in Chapter
40-5.2 entitled "The Rhode Island Works Program" are hereby amended to read as follows: