Rhode Island 2025 Regular Session

Rhode Island House Bill H5991 Compare Versions

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55 2025 -- H 5991
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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. 2025
1212 ____________
1313
1414 A N A C T
1515 RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR
1616 CHILDREN AND PREGNAN T WOMEN
1717 Introduced By: Representatives Stewart, Cruz, Alzate, Shallcross Smith, Kislak, Potter,
1818 McGaw, Voas, and Casimiro
1919 Date Introduced: February 28, 2025
2020 Referred To: House Finance
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2323 It is enacted by the General Assembly as follows:
2424 SECTION 1. Section 42-12.3-3 of the General Laws in Chapter 42-12.3 entitled "Health 1
2525 Care for Children and Pregnant Women" is hereby amended to read as follows: 2
2626 42-12.3-3. Medical assistance expansion for pregnancy/RIte Start. 3
2727 (a) The secretary of the executive office of health and human services is authorized to 4
2828 amend its Title XIX state plan pursuant to Title XIX of the Social Security Act to provide Medicaid 5
2929 coverage and to amend its Title XXI state plan pursuant to Title XXI of the Social Security Act to 6
3030 provide medical assistance coverage through expanded family income disregards for pregnant 7
3131 persons whose family income levels are between one hundred eighty-five percent (185%) and two 8
3232 hundred fifty percent (250%) of the federal poverty level. The department is further authorized to 9
3333 promulgate any regulations necessary and in accord with Title XIX [42 U.S.C. § 1396 et seq.] and 10
3434 Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security Act necessary in order to implement 11
3535 said state plan amendment. The services provided shall be in accord with Title XIX [42 U.S.C. § 12
3636 1396 et seq.] and Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security Act. 13
3737 (b) The secretary of health and human services is authorized and directed to establish a 14
3838 payor of last resort program to cover prenatal, delivery and postpartum care. The program shall 15
3939 cover the cost of maternity care for any person who lacks health insurance coverage for maternity 16
4040 care and who is not eligible for medical assistance under Title XIX [42 U.S.C. § 1396 et seq.] and 17
4141 Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security Act including, but not limited to, a 18
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4545 noncitizen pregnant person lawfully admitted for permanent residence on or after August 22, 1996, 1
4646 without regard to the availability of federal financial participation, provided such pregnant person 2
4747 satisfies all other eligibility requirements. The secretary shall promulgate regulations to implement 3
4848 this program. Such regulations shall include specific eligibility criteria; the scope of services to be 4
4949 covered; procedures for administration and service delivery; referrals for non-covered services; 5
5050 outreach; and public education. 6
5151 (c) The secretary of health and human services may enter into cooperative agreements with 7
5252 the department of health and/or other state agencies to provide services to individuals eligible for 8
5353 services under subsections (a) and (b) above. 9
5454 (d) The following services shall be provided through the program: 10
5555 (1) Ante-partum and postpartum care; 11
5656 (2) Delivery; 12
5757 (3) Cesarean section; 13
5858 (4) Newborn hospital care; 14
5959 (5) Inpatient transportation from one hospital to another when authorized by a medical 15
6060 provider; and 16
6161 (6) Prescription medications and laboratory tests. 17
6262 (e) The secretary of health and human services shall provide enhanced services, as 18
6363 appropriate, to pregnant persons as defined in subsections (a) and (b), as well as to other pregnant 19
6464 persons eligible for medical assistance. These services shall include: care coordination; nutrition 20
6565 and social service counseling; high-risk obstetrical care; childbirth and parenting preparation 21
6666 programs; smoking cessation programs; outpatient counseling for drug-alcohol use; interpreter 22
6767 services; mental health services; and home visitation. The provision of enhanced services is subject 23
6868 to available appropriations. In the event that appropriations are not adequate for the provision of 24
6969 these services, the executive office has the authority to limit the amount, scope, and duration of 25
7070 these enhanced services. 26
7171 (f) The executive office of health and human services shall provide for extended family 27
7272 planning services for up to twenty-four (24) months postpartum. These services shall be available 28
7373 to persons who have been determined eligible for RIte Start or for medical assistance under Title 29
7474 XIX [42 U.S.C. § 1396 et seq.] or Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security 30
7575 Act. 31
7676 (g) Effective October 1, 2022, individuals eligible for RIte Start pursuant to this section or 32
7777 for medical assistance under Title XIX or Title XXI of the Social Security Act while pregnant 33
7878 (including during a period of retroactive eligibility), are eligible for full Medicaid benefits through 34
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8282 the last day of the month in which their twelve-month (12) postpartum period ends. This benefit 1
8383 will be provided to eligible Rhode Island residents without regard to the availability of federal 2
8484 financial participation. The executive office of health and human services is directed to ensure that 3
8585 federal financial participation is used to the maximum extent allowable to provide coverage 4
8686 pursuant to this section, and that state-only funds will be used only if federal financial participation 5
8787 is not available. 6
8888 (h) Any person eligible for services under subsections (a) and (b) of this section, or 7
8989 otherwise eligible for medical assistance under Title XIX [42 U.S.C. § 1396 et seq.] and Title XXI 8
9090 [42 U.S.C. § 1397aa et seq.] of the Social Security Act, shall also be entitled to services for any 9
9191 termination of pregnancy permitted under § 23-4.13-2; provided, however, that no federal funds 10
9292 shall be used to pay for such services, except as authorized under federal law. 11
9393 (i) The executive office of health and human services shall provide for self-measured blood 12
9494 pressure monitoring services for pregnant and postpartum persons as medically necessary. These 13
9595 services shall be available to persons who have been determined eligible for RIte Start or for 14
9696 medical assistance under Title XIX or Title XXI of the Social Security Act. Coverage for self-15
9797 measured blood pressure monitoring shall include the provision of validated home blood pressure 16
9898 monitors, and reimbursement of health care provider and other staff time used for patient training, 17
9999 transmission of blood pressure data, interpretation of blood pressure readings and reporting, and 18
100100 the delivery of co-interventions, including educational materials or classes, behavioral change 19
101101 management, and medication management. This benefit will be provided to eligible Rhode Island 20
102102 residents without regard to the availability of federal financial participation. The executive office 21
103103 of health and human services is directed to ensure that federal financial participation is used to the 22
104104 maximum extent allowable to provide coverage pursuant to this section, and that state-only funds 23
105105 will be used only if federal financial participation is not available. 24
106106 SECTION 2. This act shall take effect upon passage. 25
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113113 EXPLANATION
114114 BY THE LEGISLATIVE COUNCIL
115115 OF
116116 A N A C T
117117 RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR
118118 CHILDREN AND PREGNAN T WOMEN
119119 ***
120120 This bill would require the executive office of health and human services to provide self-1
121121 measured blood pressure monitoring for eligible pregnant and postpartum individuals, covering 2
122122 home monitors, training, data transmission, and co-interventions, with state funds if federal aid is 3
123123 unavailable. 4
124124 This act would take effect upon passage. 5
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