Health Care Accessibility And Quality Assurance Act
Impact
One of the significant provisions within S0579 is the requirement that starting January 1, 2024, each contract with a provider for these behavioral health services must include a clause stipulating a rate increase based on the inflation rate plus an additional five percent. This requirement reflects an acknowledgment of the rising costs associated with healthcare delivery and aims to ensure that reimbursement rates for mental health services keep pace with inflation. By tying payment adjustments to a defined economic indicator, the bill seeks to stabilize provider compensation and support the sustainability of mental health services across the state.
Summary
Bill S0579, titled the Health Care Accessibility and Quality Assurance Act, aims to enhance the reporting and regulatory framework for mental health and substance use disorder services provided by healthcare entities and network plans in Rhode Island. The bill mandates that before January 1, 2024, all healthcare entities or network plans must compile and submit a report to the office of the health insurance commissioner, detailing the procedures for submitting claims for in-network outpatient behavioral health services. This transparency is intended to ensure that there is consistency and clarity in the claims process, particularly regarding the use of specific procedural terminology pertinent to behavioral health services.
Contention
Discussion surrounding S0579 may raise points of contention regarding the feasibility of implementing the mandated reporting requirements and the adequacy of the proposed rate adjustments. Stakeholders such as healthcare providers and mental health advocates might express varying opinions on whether the inflation adjustment is satisfactory or if additional enhancements are needed to address the comprehensive costs of care. Furthermore, there might be concerns about potential administrative burdens imposed on healthcare entities in compiling and reporting the required summaries, as well as the implications of these changes on patient access to care and service quality.
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.
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.
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.
Requires that healthcare entities and network plans, eff. 1/1/25, include provision in every contract with a provider of mental health/substance use disorders that rates paid pursuant to the contract would be subject to a rate increase at least annually.