Attorney General Peter F. Neronha expressed disappointment over the Rhode Island Office of the Health Insurance Commissioner's (OHIC) decision not to adopt more assertive amendments in its regulations concerning primary care.
"Fixing our health care system requires bold policy changes that address what is broken, and OHIC’s refusal to seize this opportunity is a shame," said Attorney General Neronha. He emphasized the importance of reducing prior authorization requirements, describing them as burdensome for primary care physicians and largely unnecessary since most are approved. "Doctors would have more time to see more patients, and lower prior authorization requirements would be an attractive selling point for physicians to set up shop in Rhode Island at a time when many of them are understandably seeking to practice elsewhere."
Neronha called on leadership at all levels to treat the state's healthcare situation as an emergency requiring coordinated efforts and data-driven solutions. "Our residents, our hospitals, our doctors, they all feel the negative effects of a health care system teetering on the edge of disaster," he stated.
In November 2024, Neronha's office had urged OHIC to propose stronger amendments aimed at alleviating issues caused by prior authorization requirements. However, OHIC decided against requiring more than a 20% reduction in these requirements.
Prior authorization involves insurers needing physician approval before treatments or services qualify for payment. Insurers argue it prevents unnecessary costs but many doctors believe it creates administrative burdens and undermines clinical judgment.
On March 6, 2025, OHIC finalized its proposed regulatory changes including a 20% reduction in prior authorizations among other measures like increased investment in primary care. While agreeing with these goals, Neronha criticized OHIC for lacking aggressive action and failing to base proposals on sufficient research.