AN ACT RELATING TO INSURANCE -- BENEFIT DETERMINATION AND UTILIZATION REVIEW ACT

HB 5120, the "Rhode Island Prior Authorization Reform Act of 2025," prohibits insurers from requiring prior authorization for services ordered by in-network primary care providers. This directly affects patients receiving care from in-network primary care physicians and the providers themselves, as insurers can no longer block these services through extra approval steps. The key provision mandates that insurers must approve such services without imposing prior authorization requirements, streamlining access to care. The bill aims to reduce administrative delays for routine treatments recommended by primary care providers within an insurer's network.