RI Senate unveils 17-bill package to improve health care

• Rhode Island Senate leaders have introduced a 17-bill package to address issues in the state’s health care system.
• One proposal seeks to establish a medical school at the University of Rhode Island to increase the number of primary care doctors.
• Other bills aim to provide student loan assistance and scholarships for health care professionals who commit to working in the state.
• The legislative package also includes new regulations for pharmacy benefit managers and safety guidelines for artificial intelligence in therapy.
• Additional measures would make a provider’s apology inadmissible in court and require insurance to cover all recommended immunizations without cost sharing.

PROVIDENCE – For the third year in a row, Senate leaders are seeking to fix what’s broken in Rhode Island’s health care system.

The stated goal of the 17-bill package unveiled on Thursday, March 12: “Supporting Rhode Islanders in crisis, protecting patients and providers, and strengthening the state’s health workforce.”

“For the well-being of our communities, and the future of our state, it is imperative that we do everything in our power to ensure the stability and sustainability of our health system, and to make essential care both accessible and affordable for every Rhode Islander,” Senate President Valarie Lawson said.

“While we know that solving the crisis cannot be accomplished through any single piece of legislation, or any one collection of bills, those being highlighted today build on our past progress and help address the most pressing needs of this moment,” added Sen. Melissa Murray, the chair of the Senate Committee on Health & Human Services.

Highlights

Some of the measures will sound familiar. Others reflect the recent recommendations of the legislative commission that spent months studying the arguments for and against creation of a medical school at the University of Rhode Island, before heartily recommending one.

“A state medical school would provide transformative long-term benefits for the state’s healthcare system, economy, and communities. Most critically, it would strengthen the pipeline of primary care physicians at a time when the state faces a growing shortage and an aging workforce,” the commission’s final report said.

“Without action,” the report warned, “Rhode Island risks falling further behind in physician supply workforce retention, and healthcare access, especially in primary care and underserved areas.”

Sen. V. Susan Sosnowski’s bill asks or an initial $5 million in the 2026-27 budget year to hire a “founding dean” and other staff to begin to establish the much-discussed medical school at URI to produce a permanent pipeline of much-needed primary care doctors for the state.

Her bill anticipates the need for $7 million a year later, and $8 million the year after that before the first student enrolls.

While some student loan assistance is already available for health care professionals, Sen. Hanna Gallo’s bill would commit $500,000 in state dollars to paying up to two years of medical school loans, for health care professionals who commit to working in Rhode Island for at least two years.

A related bill from Sen. Pamela Lauria’s bill would provide scholarships for students in a medical or nursing school or a “physician assistant” training program who commit to working here. (It is not yet clear how much more assistance these bills would provide than what is currently available.)

Other bills seek more regulation – and a deep-dive by the attorney general – into the “effectiveness and performance” of the controversial intermediaries in the prescription drug market known as “pharmacy benefit managers.”

Another is the latest, by Lauria, in a decades-long effort to pass an “I’m sorry” bill that makes statements of “apology or concern by a health care provider to a patient, a patient’s relative or representative … is inadmissible [in court] as evidence of liability or admission of fault.” According to its backers 39 other states have similar laws.

As The Journal wrote in 2007: Even in cases in which no medical error was involved, “doctors, hospitals and their insurers worry that any empathy expressed will be construed as an admission of wrongdoing and used against them in a lawsuit.”

In that same vein: Sen. Mark McKenney, a retired lawyer, wants to launch a study, by a 13-member special legislative commission, of “the impact of medical malpractice claims on health care providers and costs.”

Among the other highlights:

Artificial intelligence safety guidelines: One of Sen. Lori Urso’s bills seeks to prohibit the operation of “AI companion models and chatbots … unless the provider has a protocol for addressing possible suicidal ideation, self-harm, other physical harm, or financial harm.” A second would prohibit use of internet-based artificial intelligence to provide therapy by anyone other than a licensed professional, or to transcribe therapy notes without patient consent.

Vaccinations: Sen. Linda Ujifusa’s bill would require coverage of all immunizations recommended by the Department of Health by all insurers and the state Medicaid program, without any cost sharing, starting on Jan. 1, 2027.

Pharmacy benefit managers: This three-bill set would impose new rules on how these intermediaries interact with pharmacies, require they obtain “individual certificates of authority” from the Department of Business Regulation to do business in Rhode Island and mandate a study of the “performance and cost-effectiveness of the state’s current prescription drug management for the Medicaid Program.”

Emergency mental and behavioral health services: Companions bill would make both the 24/7 suicide prevention and crisis hotline currently known as “988” – and the separate program that provides the “mobile response” of trained behavioral health clinicians to children in crisis – permanent fixtures in state law, provide money to fund them, and set a minimum reimbursement rate.