2025 -- S 0096
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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 HUMAN SERVICES -- MEDICAL ASSISTANCE
Introduced By: Senators LaMountain, Dimitri, McKenney, and Patalano
Date Introduced: January 31, 2025
Referred To: Senate Finance
It is enacted by the General Assembly as follows:
SECTION 1. Section 40-8-2 of the General Laws in Chapter 40-8 entitled "Medical 1
Assistance" is hereby amended to read as follows: 2
40-8-2. Definitions. 3
As used in this chapter, unless the context shall otherwise require: 4
(1) “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, 5
palliative treatment, and the refitting and relining of existing dentures and prosthesis. 6
(2) “Department” means the department of human services. 7
(3) “Director” means the director of human services. 8
(4) “Drug” means and includes only drugs and biologicals prescribed by a licensed dentist 9
or physician as are either included in the United States pharmacopoeia, national formulary, or are 10
new and nonofficial drugs and remedies. 11
(5) “Inpatient” means a person admitted to and under treatment or care of a physician or 12
surgeon in a hospital or nursing facility that meets standards of and complies with rules and 13
regulations promulgated by the director. 14
(6) “Inpatient hospital services” means the following items and services furnished to an 15
inpatient in a hospital other than a hospital, institution, or facility for tuberculosis or mental 16
diseases: 17
(i) Bed and board; 18
(ii) Nursing services and other related services as are customarily furnished by the hospital 19
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for the care and treatment of inpatients and drugs, biologicals, supplies, appliances, and equipment 1
for use in the hospital, as are customarily furnished by the hospital for the care and treatment of 2
patients; 3
(iii)(A) Other diagnostic or therapeutic items or services, including, but not limited to, 4
pathology, radiology, and anesthesiology furnished by the hospital or by others under arrangements 5
made by the hospital, as are customarily furnished to inpatients either by the hospital or by others 6
under such arrangements, and services as are customarily provided to inpatients in the hospital by 7
an intern or resident-in-training under a teaching program having the approval of the Council on 8
Medical Education and Hospitals of the American Medical Association or of any other recognized 9
medical society approved by the director. 10
(B) The term “inpatient hospital services” shall be taken to include medical and surgical 11
services provided by the inpatient’s physician, but shall not include the services of a private-duty 12
nurse or services in a hospital, institution, or facility maintained primarily for the treatment and 13
care of patients with tuberculosis or mental diseases. Provided, further, it shall be taken to include 14
only the following organ transplant operations: kidney, liver, cornea, pancreas, bone marrow, lung, 15
heart, and heart/lung, and other organ transplant operations as may be designated by the director 16
after consultation with medical advisory staff or medical consultants; and provided that any such 17
transplant operation is determined by the director or his or her designee to be medically necessary. 18
Prior written approval of the director, or his or her designee, shall be required for all covered organ 19
transplant operations. 20
(C) In determining medical necessity for organ transplant procedures, the state plan shall 21
adopt a case-by-case approach and shall focus on the medical indications and contra-indications in 22
each instance; the progressive nature of the disease; the existence of any alternative therapies; the 23
life-threatening nature of the disease; the general state of health of the patient apart from the 24
particular organ disease; and any other relevant facts and circumstances related to the applicant and 25
the particular transplant procedure. 26
(7) “Nursing services” means the following items and services furnished to an inpatient in 27
a nursing facility: 28
(i) Bed and board; 29
(ii) Nursing care and other related services as are customarily furnished to inpatients 30
admitted to the nursing facility, and drugs, biologicals, supplies, appliances, and equipment for use 31
in the facility, as are customarily furnished in the facility for the care and treatment of patients; 32
(iii) Other diagnostic or therapeutic items or services, legally furnished by the facility or 33
by others under arrangements made by the facility, as are customarily furnished to inpatients either 34
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by the facility or by others under such arrangement; 1
(iv) Medical services provided in the facility by the inpatient’s physician, or by an intern 2
or resident-in-training of a hospital with which the facility is affiliated or that is under the same 3
control, under a teaching program of the hospital approved as provided in subsection (6); and 4
(v) A personal-needs allowance of seventy-five dollars ($75.00) one hundred dollars 5
($100) per month. 6
(8) “Relative with whom the dependent child is living” means and includes the father, 7
mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, 8
uncle, aunt, first cousin, nephew, or niece of any dependent child who maintains a home for the 9
dependent child. 10
(9) “Visiting nurse service” means part-time or intermittent nursing care provided by or 11
under the supervision of a registered professional nurse other than in a hospital or nursing home. 12
SECTION 2. This act shall take effect on July 1, 2025. 13
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE
***
This act would increase the personal needs allowance of nursing facility residents from 1
seventy-five dollars ($75.00) to one hundred dollars ($100) per month. 2
This act would take effect on July 1, 2025. 3
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