Provides that licensed independent clinical social workers be able to enroll and bill Medicaid directly for covered services provided to adults with Medicaid fee-for-service coverage.
Impact
This legislation would result in a significant alteration of Rhode Island's Medicaid reimbursement structure, specifically concerning mental health services. By enabling licensed independent clinical social workers to engage in direct billing, the bill ensures that more qualified healthcare providers are incentivized to provide essential services to adults covered under Medicaid. This could potentially lead to an increase in the availability of mental health services for low-income individuals, thereby aiming to address gaps in care and improve overall public health outcomes.
Summary
House Bill 5078 aims to enhance the accessibility of healthcare services by allowing licensed independent clinical social workers to enroll in and bill Medicaid directly for services rendered to adults with Medicaid fee-for-service coverage. This legislative change is designed to improve the delivery of mental health services, acknowledging the increasing demand for such services by ensuring they can be adequately compensated for their work. By facilitating direct billing, the bill seeks to streamline the reimbursement process for these professionals and promote their healing roles in the healthcare system.
Contention
While the bill has generally been viewed as a positive step towards increasing access to mental health services, debates may arise regarding the implications for the overall healthcare system and Medicaid budget. Conversely, stakeholders may raise concerns about the regulatory framework that governs medical billing, ensuring that appropriate measures are in place to maintain billing integrity and protect against fraud. Addressing such issues will be crucial in the discussions as the legislative process moves forward.
Provides that licensed independent clinical social workers be able to enroll and bill Medicaid directly for covered services provided to adults with Medicaid fee-for-service coverage.
Authorizes the executive office of health and human services to establish a program providing coverage for nutritional assistance and medically tailored meals for certain beneficiaries where there is a clinical need.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Requires insurance coverage for all services provided by a pharmacist provided coverage of such services would have been covered if provided by a physician, advanced practice nurse, or physician assistant.
Requires that any insurance contract issued, amended or renewed on or after January 1, 2025, that provides hospital, medical or surgical coverage shall provide coverage for medically necessary treatment of mental health or substance use disorders.
Provides that services provided by graduate student interns who work under a supervisory protocol would be eligible to be paid from Medicaid reimbursement.
Requires that Medicaid enrollment be maintained or provided to all inmates in the first 30 days of incarceration at the adult correctional institutions within the department of corrections and the last 30 days of incarceration.
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.