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