Drs. Pass and Bertherman, Inc., Providence Eye Associates, Inc.

Summary

The Rhode Island Supreme Court affirmed summary judgment for Neighborhood Health Plan of Rhode Island, holding that the plan’s differential reimbursement of ophthalmologists versus optometrists did not violate G.L. 1956 § 5‑35‑21.1(b) because the funds used were private after the state’s capitation payment and NHP is not a state actor. The Court also remanded the case to the Superior Court.