Raises the per diem rate by thirteen percent (13%) for Medicaid reimbursement for Tier C services provide by assisted living residence beginning January 1, 2026.
Impact
The bill significantly impacts state laws regarding the provision of long-term care services, potentially transforming the landscape of healthcare funding in the state. One major provision includes the authorization for the executive office of health and human services to pursue federal waivers to support these initiatives financially. It also requires annual reports on the percentage distribution of funds between institutional and community-based services, thereby increasing transparency and accountability within the state’s healthcare financing.
Summary
House Bill H6289 is focused on reforming long-term care services and financing in Rhode Island, particularly concerning Medicaid reimbursement rates and the allocation of funds toward home- and community-based care. The bill mandates that at least 50% of Medicaid long-term care funding is directed towards supporting individuals aged 65 and over and those with disabilities in home or community settings. This legislative change aims to provide more person-centered, specialized services that emphasize individual choice, family involvement, and community integration, ultimately seeking to reduce reliance on institutional care facilities.
Contention
Despite the positive intentions behind H6289, there are contentions surrounding its implementation, particularly regarding the adequacy of funding and resources for the proposed changes. There are concerns from various stakeholders, including service providers, about whether the increased focus on home- and community-based care will lead to underfunding of necessary institutional services. The bill also invites debate on balancing sufficient training and compensation for the direct-care workforce, which is critical for the success of community-based care initiatives.
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.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
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.
Increases the state’s share of supplementary assistance to individuals living in a state-licensed assisted-living residence from $332.00 to $352.00, of which $140.00 would be allocated to the personal needs allowance.
Increases the state's share of supplementary assistance to individuals living in a state-licensed assisted-living residence from $332.00 to $352.00, of which $140.00 would be allocated to the personal needs allowance.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
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.
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.