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.
Impact
H7298 is expected to have significant implications for Rhode Island's healthcare landscape. By shifting resources toward home and community-based care, the bill could reduce the reliance on institutional care facilities, leading to a greater focus on enhancing the quality of life for individuals with long-term care needs. It is designed to not only tailor services to individual needs but also prioritize investments in the home care sector which has historically faced resource constraints. This rebalancing of funding and services aims to decrease institutional stays and potentially reduce Medicaid expenditures in the long run.
Summary
House Bill H7298 focuses on reforming the long-term care service and finance system under the Department of Human Services. The bill mandates that at least 50% of Medicaid long-term care funding is allocated to home and community-based care, emphasizing the need for person-centered care. This approach aims to assist individuals with disabilities and the elderly in receiving services in more supportive environments, rather than traditional institutional settings. Through the establishment of new reimbursement rates and streamlining administrative processes, the bill aims to enhance the efficiency and effectiveness of care delivery in Rhode Island.
Contention
Debate surrounding H7298 is likely to center on its financial implications and the feasibility of transitioning to a predominantly home- and community-based care model. Supporters argue that investing in home care can lead to better health outcomes and cost savings, while critics may express concerns about the adequacy of funding for community services and whether the transition could disrupt existing care continuity. Additionally, there are worries about whether the state can adequately recruit and retain home care workers, which is crucial for the success of the envisioned reforms.
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.
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.
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.
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.