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5 | 5 | | 2025 -- H 5991 |
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6 | 6 | | ======== |
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7 | 7 | | LC001981 |
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8 | 8 | | ======== |
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9 | 9 | | S T A T E O F R H O D E I S L A N D |
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10 | 10 | | IN GENERAL ASSEMBLY |
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11 | 11 | | JANUARY SESSION, A.D. 2025 |
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12 | 12 | | ____________ |
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13 | 13 | | |
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14 | 14 | | A N A C T |
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15 | 15 | | RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR |
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16 | 16 | | CHILDREN AND PREGNAN T WOMEN |
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17 | 17 | | Introduced By: Representatives Stewart, Cruz, Alzate, Shallcross Smith, Kislak, Potter, |
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18 | 18 | | McGaw, Voas, and Casimiro |
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19 | 19 | | Date Introduced: February 28, 2025 |
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20 | 20 | | Referred To: House Finance |
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21 | 21 | | |
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22 | 22 | | |
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23 | 23 | | It is enacted by the General Assembly as follows: |
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24 | 24 | | SECTION 1. Section 42-12.3-3 of the General Laws in Chapter 42-12.3 entitled "Health 1 |
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25 | 25 | | Care for Children and Pregnant Women" is hereby amended to read as follows: 2 |
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26 | 26 | | 42-12.3-3. Medical assistance expansion for pregnancy/RIte Start. 3 |
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27 | 27 | | (a) The secretary of the executive office of health and human services is authorized to 4 |
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28 | 28 | | amend its Title XIX state plan pursuant to Title XIX of the Social Security Act to provide Medicaid 5 |
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29 | 29 | | coverage and to amend its Title XXI state plan pursuant to Title XXI of the Social Security Act to 6 |
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30 | 30 | | provide medical assistance coverage through expanded family income disregards for pregnant 7 |
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31 | 31 | | persons whose family income levels are between one hundred eighty-five percent (185%) and two 8 |
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32 | 32 | | hundred fifty percent (250%) of the federal poverty level. The department is further authorized to 9 |
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33 | 33 | | promulgate any regulations necessary and in accord with Title XIX [42 U.S.C. § 1396 et seq.] and 10 |
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34 | 34 | | Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security Act necessary in order to implement 11 |
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35 | 35 | | said state plan amendment. The services provided shall be in accord with Title XIX [42 U.S.C. § 12 |
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36 | 36 | | 1396 et seq.] and Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security Act. 13 |
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37 | 37 | | (b) The secretary of health and human services is authorized and directed to establish a 14 |
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38 | 38 | | payor of last resort program to cover prenatal, delivery and postpartum care. The program shall 15 |
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39 | 39 | | cover the cost of maternity care for any person who lacks health insurance coverage for maternity 16 |
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40 | 40 | | care and who is not eligible for medical assistance under Title XIX [42 U.S.C. § 1396 et seq.] and 17 |
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41 | 41 | | 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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42 | 42 | | |
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43 | 43 | | |
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44 | 44 | | LC001981 - Page 2 of 4 |
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45 | 45 | | noncitizen pregnant person lawfully admitted for permanent residence on or after August 22, 1996, 1 |
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46 | 46 | | without regard to the availability of federal financial participation, provided such pregnant person 2 |
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47 | 47 | | satisfies all other eligibility requirements. The secretary shall promulgate regulations to implement 3 |
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48 | 48 | | this program. Such regulations shall include specific eligibility criteria; the scope of services to be 4 |
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49 | 49 | | covered; procedures for administration and service delivery; referrals for non-covered services; 5 |
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50 | 50 | | outreach; and public education. 6 |
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51 | 51 | | (c) The secretary of health and human services may enter into cooperative agreements with 7 |
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52 | 52 | | the department of health and/or other state agencies to provide services to individuals eligible for 8 |
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53 | 53 | | services under subsections (a) and (b) above. 9 |
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54 | 54 | | (d) The following services shall be provided through the program: 10 |
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55 | 55 | | (1) Ante-partum and postpartum care; 11 |
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56 | 56 | | (2) Delivery; 12 |
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57 | 57 | | (3) Cesarean section; 13 |
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58 | 58 | | (4) Newborn hospital care; 14 |
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59 | 59 | | (5) Inpatient transportation from one hospital to another when authorized by a medical 15 |
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60 | 60 | | provider; and 16 |
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61 | 61 | | (6) Prescription medications and laboratory tests. 17 |
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62 | 62 | | (e) The secretary of health and human services shall provide enhanced services, as 18 |
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63 | 63 | | appropriate, to pregnant persons as defined in subsections (a) and (b), as well as to other pregnant 19 |
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64 | 64 | | persons eligible for medical assistance. These services shall include: care coordination; nutrition 20 |
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65 | 65 | | and social service counseling; high-risk obstetrical care; childbirth and parenting preparation 21 |
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66 | 66 | | programs; smoking cessation programs; outpatient counseling for drug-alcohol use; interpreter 22 |
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67 | 67 | | services; mental health services; and home visitation. The provision of enhanced services is subject 23 |
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68 | 68 | | to available appropriations. In the event that appropriations are not adequate for the provision of 24 |
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69 | 69 | | these services, the executive office has the authority to limit the amount, scope, and duration of 25 |
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70 | 70 | | these enhanced services. 26 |
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71 | 71 | | (f) The executive office of health and human services shall provide for extended family 27 |
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72 | 72 | | planning services for up to twenty-four (24) months postpartum. These services shall be available 28 |
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73 | 73 | | to persons who have been determined eligible for RIte Start or for medical assistance under Title 29 |
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74 | 74 | | XIX [42 U.S.C. § 1396 et seq.] or Title XXI [42 U.S.C. § 1397aa et seq.] of the Social Security 30 |
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75 | 75 | | Act. 31 |
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76 | 76 | | (g) Effective October 1, 2022, individuals eligible for RIte Start pursuant to this section or 32 |
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77 | 77 | | for medical assistance under Title XIX or Title XXI of the Social Security Act while pregnant 33 |
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78 | 78 | | (including during a period of retroactive eligibility), are eligible for full Medicaid benefits through 34 |
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79 | 79 | | |
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80 | 80 | | |
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81 | 81 | | LC001981 - Page 3 of 4 |
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82 | 82 | | the last day of the month in which their twelve-month (12) postpartum period ends. This benefit 1 |
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83 | 83 | | will be provided to eligible Rhode Island residents without regard to the availability of federal 2 |
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84 | 84 | | financial participation. The executive office of health and human services is directed to ensure that 3 |
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85 | 85 | | federal financial participation is used to the maximum extent allowable to provide coverage 4 |
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86 | 86 | | pursuant to this section, and that state-only funds will be used only if federal financial participation 5 |
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87 | 87 | | is not available. 6 |
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88 | 88 | | (h) Any person eligible for services under subsections (a) and (b) of this section, or 7 |
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89 | 89 | | otherwise eligible for medical assistance under Title XIX [42 U.S.C. § 1396 et seq.] and Title XXI 8 |
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90 | 90 | | [42 U.S.C. § 1397aa et seq.] of the Social Security Act, shall also be entitled to services for any 9 |
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91 | 91 | | termination of pregnancy permitted under § 23-4.13-2; provided, however, that no federal funds 10 |
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92 | 92 | | shall be used to pay for such services, except as authorized under federal law. 11 |
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93 | 93 | | (i) The executive office of health and human services shall provide for self-measured blood 12 |
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94 | 94 | | pressure monitoring services for pregnant and postpartum persons as medically necessary. These 13 |
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95 | 95 | | services shall be available to persons who have been determined eligible for RIte Start or for 14 |
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96 | 96 | | medical assistance under Title XIX or Title XXI of the Social Security Act. Coverage for self-15 |
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97 | 97 | | measured blood pressure monitoring shall include the provision of validated home blood pressure 16 |
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98 | 98 | | monitors, and reimbursement of health care provider and other staff time used for patient training, 17 |
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99 | 99 | | transmission of blood pressure data, interpretation of blood pressure readings and reporting, and 18 |
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100 | 100 | | the delivery of co-interventions, including educational materials or classes, behavioral change 19 |
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101 | 101 | | management, and medication management. This benefit will be provided to eligible Rhode Island 20 |
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102 | 102 | | residents without regard to the availability of federal financial participation. The executive office 21 |
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103 | 103 | | of health and human services is directed to ensure that federal financial participation is used to the 22 |
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104 | 104 | | maximum extent allowable to provide coverage pursuant to this section, and that state-only funds 23 |
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105 | 105 | | will be used only if federal financial participation is not available. 24 |
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106 | 106 | | SECTION 2. This act shall take effect upon passage. 25 |
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107 | 107 | | ======== |
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108 | 108 | | LC001981 |
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109 | 109 | | ======== |
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110 | 110 | | |
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111 | 111 | | |
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112 | 112 | | LC001981 - Page 4 of 4 |
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113 | 113 | | EXPLANATION |
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114 | 114 | | BY THE LEGISLATIVE COUNCIL |
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115 | 115 | | OF |
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116 | 116 | | A N A C T |
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117 | 117 | | RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR |
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118 | 118 | | CHILDREN AND PREGNAN T WOMEN |
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119 | 119 | | *** |
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120 | 120 | | This bill would require the executive office of health and human services to provide self-1 |
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121 | 121 | | measured blood pressure monitoring for eligible pregnant and postpartum individuals, covering 2 |
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122 | 122 | | home monitors, training, data transmission, and co-interventions, with state funds if federal aid is 3 |
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123 | 123 | | unavailable. 4 |
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124 | 124 | | This act would take effect upon passage. 5 |
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125 | 125 | | ======== |
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126 | 126 | | LC001981 |
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127 | 127 | | ======== |
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