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

SB 168, the Rhode Island Prior Authorization Reform Act of 2025, prevents insurance companies from requiring prior approval (where patients or doctors must get insurance permission before a service) for any medical service ordered by an in-network primary care provider. This means patients can receive care recommended by their primary care doctor without waiting for insurance review, directly affecting patients, primary care providers, and insurers. The key provision prohibits insurers from imposing prior authorization for these services, streamlining access to care. The bill applies to all health insurance plans operating in Rhode Island, removing a common administrative barrier for routine primary care referrals.