Requires reimbursement for medical, dental, and behavioral health services provided at community health care centers to equal the lesser of the actual cost, based on Medicaid reports, or 125% of the median rate for all community health centers within RI.
Impact
The implementation of HB H6046 is expected to positively impact the financial stability of community health centers by providing a more predictable and equitable reimbursement structure. By basing reimbursements on actual service costs or a defined standard, it addresses the challenges faced by these centers in sustaining their services. This change could potentially increase the quality of care provided as centers may have better financial resources to hire qualified staff, maintain facilities, and invest in necessary equipment.
Summary
House Bill H6046 amends existing Rhode Island law related to community health centers, specifically addressing reimbursement rates for medical, dental, and behavioral health services provided at these facilities. The bill mandates that reimbursements equal the lesser of actual costs based on Medicaid reports or 125% of the median rates for all community health centers within Rhode Island. This framework aims to ensure fair compensation for services rendered at these facilities, thereby supporting their operational viability and promoting access to essential health services for Rhode Island residents.
Contention
Despite the potential benefits, there could be contention surrounding how 'actual costs' are determined and reported. Some stakeholders may argue that the reimbursement rates established by this bill may not fully reflect the diverse needs of different community health centers, especially those in underserved areas. Additionally, the requirement for timely cooperation with reporting standards set by the executive office may pose administrative burdens for some operators.
Notable_points
HB H6046 requires close collaboration between community health centers and the executive office of health and human services to establish and adhere to reimbursement rates. The emphasis on compliance with prior legislation, such as the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, indicates a focus on aligning state practices with federal standards, which may foster greater collaboration between state and federal health initiatives.
JOINT RESOLUTION TO AMEND THE MEDICAID SECTION 1115 DEMONSTRATION WAIVER REQUESTS AND RENEWALS (Approves an amendment to a Medicaid section 1115 demonstration waiver to mandate that the EOHHS propose a 13% raise to provider reimbursement rates for immediate care facilities, including certified community behavioral health centers.)
Establishes a universal, comprehensive, affordable single-payer health care insurance program and helps control health care costs, which would be referred to as, "the Rhode Island Comprehensive Health Insurance Program" (RICHIP).
Establishes a universal, comprehensive, affordable single-payer health care insurance program and helps control health care costs, which would be referred to as, "the Rhode Island Comprehensive Health Insurance Program" (RICHIP).
Requires that the department of human services and the department of behavioral healthcare, developmental disabilities and hospitals provide forecasted costs reflecting the recommended rate review on a monthly basis.
Requires that the department of human services and the department of behavioral healthcare, developmental disabilities and hospitals provide forecasted costs reflecting the recommended rate review on a monthly basis.
Prohibits contractors and subcontractors from paying employees the cash equivalent of any applicable healthcare benefit in lieu of actually purchasing the healthcare benefit unless the employee is covered under a different healthcare plan.
All Medicaid programs operated by EOHHS would not reimburse home care providers less than fee-for-service rates adopted by rate review recommendations of the office of health insurance commissioners.
Authorizes emergency medical service agencies to transport individuals to alternative facilities for treatment and permits licensed providers for mental health disorders to treat patients within the community.
Establishes the right of a medical practitioner, healthcare institution, or healthcare payer not to participate in or pay for any medical procedure or service this violates their conscience.