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Rhode Island Senate Bill S0873

Rhode Island 2023 Regular Session

Rhode Island Senate Bill S0873 Compare Versions

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99 S T A T E O F R H O D E I S L A N D
1010 IN GENERAL ASSEMBLY
1111 JANUARY SESSION, A.D. 2023
1212 ____________
1313
1414 A N A C T
1515 RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE MEDICAID REENTRY
1616 ACT
1717 Introduced By: Senators Lawson, Lauria, LaMountain, Miller, Kallman, Cano, Euer,
1818 DiMario, Valverde, and Mack
1919 Date Introduced: March 30, 2023
2020 Referred To: Senate Health & Human Services
2121
2222
2323 It is enacted by the General Assembly as follows:
2424 SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND 1
2525 GOVERNMENT" is hereby amended by adding thereto the following chapter: 2
2626 CHAPTER 56.4 3
2727 THE MEDICAID REENTRY ACT 4
2828 42-56.4-1. Short title. 5
2929 This chapter shall be known and may be cited as the "The Medicaid Reentry Act." 6
3030 42-56.4-2. Legislative findings and intent. 7
3131 The general assembly finds and declares that: 8
3232 (1) Having access to same day and next day physical and behavioral health services is 9
3333 imperative to facilitate successful reentry for individuals released from incarceration; 10
3434 (2) Suspending Medicaid enrollment for incarcerated individuals causes significant delays 11
3535 in Medicaid reinstatement upon release; 12
3636 (3) Delays in Medicaid reinstatement impedes access to physical and behavioral health 13
3737 appointments and prescription medications upon release; and 14
3838 (4) The intent of this chapter is to facilitate successful reentry by not suspending Medicaid 15
3939 enrollment for individuals who are incarcerated and providing Medicaid coverage for those 16
4040 reentering the community. 17
4141 42-56.4-3. Definitions. 18
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4545 As used in this chapter, the following words and terms shall have the following meanings: 1
4646 (1) "Coverage" means and shall include, but is not limited to: 2
4747 (i) Assessments; 3
4848 (ii) Psychosocial counseling; 4
4949 (iii) Medications, including long-acting injectable medications; 5
5050 (iv) Peer support services; 6
5151 (v) Discharge planning; and 7
5252 (vi) Reentry services. 8
5353 (2) "Medical assistance" means the medical assistance program provided by the Rhode 9
5454 Island medical assistance program, as defined under chapter 8 of title 40, or medical assistance 10
5555 provided by a managed care organization under contract with the Rhode Island medical assistance 11
5656 program. 12
5757 (3) "Qualified inmate" means an individual who is incarcerated within the adult 13
58-correctional institutions or a juvenile correctional facility. 14
59-42-56.4-4. Maintenance of medical assistance enrollment for incarcerated individuals. 15
60-(a) During the first thirty (30) days of a person's incarceration at the department of 16
61-corrections or in a juvenile correctional facility, a person's incarceration status may not affect the 17
62-person's enrollment in medical assistance if the person is enrolled in medical assistance upon 18
63-incarceration. The person's medical assistance enrollment shall be maintained throughout the first 19
64-thirty (30) days of the person's incarceration. 20
65-(b) If a person is not currently enrolled in medical assistance upon incarceration, the 21
66-executive office of health and human services, in consultation with the department of corrections, 22
67-shall, upon the person's consent, determine the person's eligibility and enroll the person in medical 23
68-assistance upon entry within the department of corrections. Once enrolled in medical assistance, 24
69-the person's medical assistance enrollment shall be maintained throughout the first thirty (30) days 25
70-of the person's incarceration. 26
71-(c) After the first thirty (30) days of the person's incarceration, the person's medical 27
72-assistance enrollment is subject to suspension. 28
73-(d) The department of corrections shall, when possible, notify the executive office of health 29
74-and human services of the individual's upcoming release from incarceration with sufficient time to 30
75-allow the executive office of health and human services to update the individual’s enrollment in 31
76-medical assistance from suspended to active status thirty (30) days prior to release. Upon receipt 32
77-of the notification, the executive office of health and human services shall update the individua l's 33
78-enrollment in medical assistance from suspended to active status. If the person was unenrolled in 34
58+correctional institutions and has: 14
59+(i) A chronic physical or behavioral health condition; 15
60+(ii) A mental illness; or 16
61+(iii) A substance use disorder. 17
62+42-56.4-4. Maintenance of medical assistance enrollment for incarcerated individuals. 18
63+(a) During the first thirty (30) days of a person's incarceration at the department of 19
64+corrections, a person's incarceration status may not affect the person's enrollment in medical 20
65+assistance if the person is enrolled in medical assistance upon incarceration. The person's medical 21
66+assistance enrollment shall be maintained throughout the first thirty (30) days of the person's 22
67+incarceration. 23
68+(b) If a person is not currently enrolled in medical assistance upon incarceration, the 24
69+executive office of health and human services, in consultation with the department of corrections, 25
70+shall, upon the person's consent, determine the person's eligibility and enroll the person in medical 26
71+assistance upon entry within the department of corrections. Once enrolled in medical assistance, 27
72+the person's medical assistance enrollment shall be maintained throughout the first thirty (30) days 28
73+of the person's incarceration. 29
74+(c) After the first thirty (30) days of the person's incarceration, the person's medical 30
75+assistance enrollment is subject to suspension or the person's enrollment shall be maintained in 31
76+suspension status throughout the person's incarceration. 32
77+(d) Thirty (30) days prior to the individual's approximate release date from incarceration, 33
78+the department of corrections shall, when possible, notify the executive office of health and human 34
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82-medical assistance during their incarceration, the executive office of health and human services, 1
83-shall, upon the person's consent, determine the person's eligibility and enroll the person in medical 2
84-assistance. The individuals Medicaid member information shall be provided to individuals prior to 3
85-their release. 4
86-(e) Notwithstanding any provision of this section to the contrary, the executive office of 5
87-health and human services shall not be required to provide medical assistance benefits to persons 6
88-who are incarcerated prior to the person's release unless the executive office of health and human 7
89-services obtains final approval of a demonstration waiver under § 1115 (42 U.S.C. 1315) from the 8
90-Centers for Medicare and Medicaid Services. No federal funds may be expended for any purpose 9
91-that is not authorized by the state's agreements with the federal government. The executive office 10
92-of health and human services shall utilize and maximize federal funding participation when 11
93-available. 12
94-(f) The executive office of health and human services shall coordinate with the managed 13
95-care organizations for the purposes of reconciling any potential financial implications of 14
96-maintaining active coverage for the first and last thirty (30) days of an individual's confinement. 15
97-(g) The executive office of health and human services shall require through amending 16
98-current and future medical assistance managed care contracts, that the managed care organizations 17
99-meet the provisions of this chapter. 18
100-(h) The department of corrections shall make reasonable efforts to collaborate with the 19
101-executive office of health and human services and managed care organizations for the purposes of 20
102-care coordination activities, improving health care delivery, and release planning for persons 21
103-incarcerated. 22
104-(i) The executive office of health and human services and the department of corrections 23
105-shall provide all monitoring and evaluation reports required under the 1115 Demonstration Waiver 24
106-if the Centers for Medicare and Medicaid Services waives the inmate exclusion policy in their 25
107-approval of the demonstration. 26
108-42-56.4-5. Medicaid waiver for coverage of qualified inmates leaving the department 27
109-of corrections. 28
110-(a) Within ninety (90) days after the effective date of this chapter, the executive office of 29
111-health and human services, in consultation with the department of corrections, shall apply for a 30
112-demonstration waiver, under § 1115 (42 U.S.C. 1315), with the Centers for Medicare and Medicaid 31
113-Services to offer, when possible, a program to provide Medicaid benefits to a qualified inmate for 32
114-up to at least thirty (30) days immediately before the day on which the qualified inmate is released 33
115-by the department of corrections. 34
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82+services of the individual's upcoming release from incarceration. Upon receipt of the notification, 1
83+the executive office of health and human services shall reinstate the individual's enrollment in 2
84+medical assistance. If the person was unenrolled in medical assistance during their incarceration, 3
85+the executive office of health and human services, shall, upon the person's consent, determine the 4
86+person's eligibility and enroll the person in medical assistance. Medical assistance identity cards 5
87+shall be provided to individuals prior to their release. 6
88+(e) Notwithstanding any provision of this section to the contrary, the executive office of 7
89+health and human services shall not be required to provide medical assistance benefits to persons 8
90+who are incarcerated prior to the person's release unless the executive office of health and human 9
91+services obtains final approval of a demonstration waiver under § 1115 (42 U.S.C. 1315) from the 10
92+Centers for Medicare and Medicaid Services. No federal funds may be expended for any purpose 11
93+that is not authorized by the state's agreements with the federal government. The executive office 12
94+of health and human services shall utilize and maximize federal funding participation when 13
95+available. 14
96+(f) The executive office of health and human services shall coordinate with the managed 15
97+care organizations for the purposes of reconciling any potential financial implications of 16
98+maintaining an incarcerated person's medical assistance enrollment. 17
99+(g) The executive office of health and human services shall require through amending 18
100+current and future medical assistance managed care contracts, that the managed care organizations 19
101+meet the provisions of this chapter. 20
102+(h) The department of corrections shall make reasonable efforts to collaborate with the 21
103+executive office of health and human services and managed care organizations for the purposes of 22
104+care coordination activities, improving health care delivery, and release planning for persons 23
105+incarcerated. 24
106+(i) The executive office of health and human services and the department of corrections 25
107+shall report to the governor, the house of representatives committee on finance, the senate 26
108+committee on finance, the house of representatives committee on health and human services, and 27
109+the senate committee on health and human services each year before November 30 regarding: 28
110+(1) The cost of the program; and 29
111+(2) The effectiveness of the program, including: 30
112+(i) Any reduction in the number of emergency room visits or hospitalizations by inmates 31
113+after release from a correctional facility; 32
114+(ii) Any reduction in the number of inmates undergoing inpatient treatment after release 33
115+from a correctional facility; 34
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119-(b) If the waiver described in subsection (a) of this section is approved, the executive office 1
120-of health and human services shall provide all monitoring and evaluation reports required under the 2
121-1115 demonstration. 3
122-SECTION 2. This act shall take effect on January 1, 2025. 4
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119+(iii) Any reduction in overdose rates and deaths of inmates after release from a correctional 1
120+facility; 2
121+(iv) Any reduction in recidivism after release from a correctional facility; and 3
122+(v) Any other costs or benefits resulting from the program. 4
123+42-56.4-5. Medicaid waiver for coverage of qualified inmates leaving the department 5
124+of corrections. 6
125+(a) Within ninety (90) days after the effective date of this chapter, the executive office of 7
126+health and human services, in consultation with the department of corrections, shall apply for a 8
127+demonstration waiver, under § 1115 (42 U.S.C. 1315), with the Centers for Medicare and Medicaid 9
128+Services to offer, when possible, a program to provide Medicaid benefits to a qualified inmate for 10
129+up to at least thirty (30) days immediately before the day on which the qualified inmate is released 11
130+by the department of corrections. 12
131+(b) If the waiver described in subsection (a) of this section is approved, the executive office 13
132+of health and human services shall report to the governor, the house of representatives committee 14
133+on finance, senate committee on finance, house of representatives committee on health and human 15
134+services, and senate committee on health and human services each year before November 30 while 16
135+the waiver is in effect regarding: 17
136+(1) The number of qualified inmates served under the program; 18
137+(2) The cost of the program; and 19
138+(3) The effectiveness of the program, including: 20
139+(i) Any reduction in the number of emergency room visits or hospitalizations by inmates 21
140+after release from a correctional facility; 22
141+(ii) Any reduction in the number of inmates undergoing inpatient treatment after release 23
142+from a correctional facility; 24
143+(iii) Any reduction in overdose rates and deaths of inmates after release from a correctional 25
144+facility; 26
145+(iv) Any reduction in recidivism after release from a correctional facility; and 27
146+(v) Any other costs or benefits as a result of the program. 28
147+SECTION 2. This act shall take effect on January 1, 2025. 29
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129154 EXPLANATION
130155 BY THE LEGISLATIVE COUNCIL
131156 OF
132157 A N A C T
133158 RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE MEDICAID REENTRY
134159 ACT
135160 ***
136161 This act would require that Medicaid enrollment be maintained or provided to all inmates 1
137162 in the first thirty (30) days of incarceration at the adult correctional institutions within the 2
138163 department of corrections and the last thirty (30) days of incarceration when possible. It would also 3
139164 require that the executive office of health and human services, in accordance with federal law, apply 4
140165 for an § 1115 waiver to offer a program to provide Medicaid benefits to a qualified inmate for up 5
141166 to at least thirty (30) days immediately before the day on which the qualified inmate is released by 6
142167 the department of corrections. 7
143168 This act would take effect on January 1, 2025. 8
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