Rhode Island 2025 Regular Session

Rhode Island House Bill H5988 Compare Versions

Only one version of the bill is available at this time.

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5	5	2025 -- H 5988
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7	7	LC001642
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
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13	13
14	14	A N A C T
15	15	RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR
16	16	CHILDREN AND PREGNAN T WOMEN
17	17	Introduced By: Representatives Tanzi, Handy, Ajello, McGaw, Kislak, Hull, Carson,
18	18	Morales, Potter, and Cortvriend
19	19	Date Introduced: February 28, 2025
20	20	Referred To: House Finance
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23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Legislative findings. The general assembly finds and declares: 1
25	25	(1) Rhode Island pediatricians are facing a major workforce crisis which is causing 2
26	26	decreased healthcare access for children. Without significant intervention, the situation is expected 3
27	27	to worsen and negatively impact not only the health or our children, but the long-term health of the 4
28	28	adults in our state. 5
29	29	(2) According to a 2024 survey of Rhode Island pediatricians, less than fifty percent (50%) 6
30	30	of pediatric primary care offices were accepting new or transfer patients other than newborns or 7
31	31	siblings of current patients. Families that move to Rhode Island to work, or those whose pediatric 8
32	32	providers retire, cannot find a doctor to care for their child. 9
33	33	(3) The same survey showed that forty-two (42) of one hundred fifty-six (156), twenty-six 10
34	34	and nine-tenths percent (26.9%) of respondents, stated that they plan to retire within the next six 11
35	35	(6) years. This correlates to a potential loss of seventy-one (71) providers when applied to the two 12
36	36	hundred sixty-two (262) pediatricians who are currently practicing primary care in Rhode Island, 13
37	37	and a projected net loss of forty (40) to forty-five (45) providers by 2030. Current providers do not 14
38	38	have the capacity to increase panel size to accommodate more patients as most are working with 15
39	39	full patient loads. 16
40	40	(4) Rhode Island also suffers from shortages in pediatric subspecialists and child 17
41	41	psychiatrists, causing unnecessary delays in care for children. The American Academy of Pediatrics 18
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45	45	has predicted that despite increasing medical complexity of American children, the supply of 1
46	46	specialists will continue to decline without significant investments in the workforce. In Rhode 2
47	47	Island, current Medicaid payment rates for pediatric specialists is lower than that for general 3
48	48	pediatricians, as they were not included in the last rate increase in the governor’s budget. 4
49	49	(5) On average, Medicaid payment rates in Rhode Island are approximately twenty-five 5
50	50	percent (25%) lower than those in Massachusetts and Connecticut, which causes significant 6
51	51	difficulty in recruiting new pediatric providers to our state. 7
52	52	(6) Medicaid rates have a significant impact on the availability of pediatric health care to 8
53	53	children statewide, regardless of income. Nationally and in Rhode Island, pediatric health care 9
54	54	providers are more dependent on Medicaid than adult health care providers to keep their practices 10
55	55	open and operating because Medicaid covers a large portion of children’s health care. In Rhode 11
56	56	Island in 2022, fifty-eight percent (58%) of children under age seven (7), and fifty-four percent 12
57	57	(54%) of children ages zero to eighteen (18) were covered by Medicaid insurance. Only eight 13
58	58	percent (8%) of Rhode Islanders over age nineteen (19) were covered by Medicaid. In 2019, 14
59	59	children represented about twenty-five percent (25%) of the U.S. population, yet received less than 15
60	60	ten percent (10%) of total health care spending. 16
61	61	(7) Spending on health care during childhood has been documented to improve health into 17
62	62	adulthood, thereby reducing future costs. Investments in children’s health care can produce 18
63	63	improved outcomes in subsequent generations. 19
64	64	SECTION 2. Chapter 42-12.3 of the General Laws entitled "Health Care for Children and 20
65	65	Pregnant Women" is hereby amended by adding thereto the following section: 21
66	66	42-12.3-17. Access to pediatric health care. 22
67	67	The executive office of health and human services shall pursue a Medicaid state plan 23
68	68	amendment and allocate sufficient state general revenue to increase Medicaid payment rates to 24
69	69	equal one hundred thirty percent (130%) of Medicare rates for all payment codes for outpatient 25
70	70	clinical services rendered to patients under nineteen (19) years old on or before October 1, 2025 to 26
71	71	ensure rates allow pediatric providers to provide adequate services for their current patient panels. 27
72	72	Increased rates will allow practices to recruit and retain pediatric providers to include, but not be 28
73	73	limited to, pediatricians, pediatric specialists, child psychiatrists, family medicine physicians, nurse 29
74	74	practitioners, and physician’s assistants to improve the current workforce shortage, and offset the 30
75	75	projected shortfall in replacing physicians who plan to retire. 31
76	76	SECTION 3. This act shall take effect upon passage. 32
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83	83	EXPLANATION
84	84	BY THE LEGISLATIVE COUNCIL
85	85	OF
86	86	A N A C T
87	87	RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR
88	88	CHILDREN AND PREGNAN T WOMEN
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90	90	This act would require the executive office of health and human services to amend the state 1
91	91	Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an 2
92	92	amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical 3
93	93	pediatric services. 4
94	94	This act would take effect upon passage. 5
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