Amends the current law in order that a health insurer would not require a physician, to participate in "capitation," or any other "alternative payment model" that creates a financial incentive for a physician to limit medically necessary care.
JOINT RESOLUTION MAKING AN APPROPRIATION OF $1,000,000 TO THE RHODE ISLAND FOOD BANK (Authorizes the appropriation of the sum of $450,000 to the Rhode Island Food Bank.)
Requires the EOHHS to amend the state Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical pediatric services.
Caps the total amount that a covered person is required to pay for a covered prescription inhaler, prescription device, or prescription equipment to twenty-five dollars ($25.00) per thirty (30) day supply.
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.
Establishes the Wholesale Prescription Drug Importation Program for the importation of wholesale prescription drugs from Canada, to provide savings to Rhode Island consumers.
Establishes a rare disease advisory council within the department of health to provide guidance and recommendations to educate healthcare providers and the citizens of the state.
Limits prior authorization requirements for rehabilitative and habilitative services. Also prohibits prior authorization for the first twelve (12) visits of a new episode of care and for ninety (90) days following a chronic pain diagnosis.
Establishes a process whereby large drug manufacturers, may be penalized for prescription drug price increases where there is no, or inadequate, new evidence to support the price increase.
Establishes that Medicaid eligibility in RI can only be determined using state-controlled data, prohibit private entity data in eligibility decisions, and ensure terminations are made by human employees rather than automated systems.