Committee hears bill to let primary care practices charge $10/month from commercially insured patients

Representative Marie Hopkins introduced House Bill 6353, the Primary Care Preservation Act, at the House Committee on Corporations on June 5, 2025, proposing a voluntary, contract-law change to let primary care providers collect a capped practice support fee from commercially insured patients to shore up struggling practices.

Hopkins said Rhode Island faces a primary care crisis and framed the bill as a narrow, market-based tool to keep practices open. "This is a hail Mary," Hopkins said, describing a cap of $10 per patient per month (or $120 per year), with Medicare and Medicaid patients carved out and a family cap to be added in drafting. She told the committee the measure would be voluntary and that nurse practitioners would be included in revisions.

Three physician witnesses described the financial pressures facing private practices and supported the bill. Dr. Nathan Baraha, retired medical director and former CEO of Anchor Medical Associates, said the proposal "suggests a payment of $10 per patient per month," and that "were such a payment applied across our entire practice, this would have been enough for Anchor to stay open." He added that a slightly higher amount, "perhaps $15 per patient per month," might better support recruitment and retention.

Dr. Frank D'Alessandro, who said his organization expects to serve up to 30,000 patients this year, testified that current provider contracts with insurers bar charging additional fees and that permitting a $10 monthly contribution from commercially insured patients would provide immediate revenue to hire staff and providers. "If this bill were enacted a year ago, it is very likely Anchor Medical would not have closed," D'Alessandro said, citing the abrupt closure as evidence of the financial strain.

Dr. Jonathan Martin said restrictive insurer contracts, uncompensated administrative burdens and flat reimbursement have hollowed out private practice. "Private practice primary care is the cornerstone of a functioning health care system," Martin said, arguing that a steady per-member per-month payment would give practices predictable cash flow.

During questioning, Representative Potter asked about the impact of Anchor's closure and payer mix. Dr. Baraha said the majority of Anchor's former patient panel was commercially insured but did not provide precise breakdowns. Potter also asked whether eliminating prior authorization requirements would have yielded similar administrative savings; witnesses said prior authorization staff existed but could not quantify the full administrative savings and that such reductions likely would not replace the steady revenue a per-member fee would provide.

Representative Spears pressed witnesses on whether insurer-driven programs and data reporting had improved outcomes; witnesses described experience with large corporate models and said they had not seen consistent outcome improvements from those programs.

Sponsor Hopkins and witnesses emphasized the bill does not mandate fees and would not apply to Medicare or Medicaid patients; they said the change is limited to allowing private contract terms now prohibited by payer agreements. Hopkins said she would work with stakeholders to add a family cap and other guardrails to address optics and financial fairness.

The committee did not take a final vote on HB6353 at the June 5 session; the hearing concluded after testimony and questions, and the committee adjourned.

Ending: The bill remains under committee consideration; sponsors said they will redraft details including explicit family limits and inclusion of nurse practitioners.