Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0412 Compare Versions

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

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5	5	2025 -- S 0412
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7	7	LC001761
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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
12	12	____________
13	13
14	14	J O I N T R E S O L U T I O N
15	15	TO AMEND THE MEDICAID SECTION 1115 DEMONSTRATION WAIVER REQUE STS
16	16	AND RENEWALS – RHODE ISLAND MEDICAID REFORM ACT OF 2008
17	17	Introduced By: Senators Tikoian, Ciccone, Burke, Lawson, Patalano, Urso, Dimitri,
18	18	Rogers, Thompson, and Gu
19	19	Date Introduced: February 26, 2025
20	20	Referred To: Senate Finance
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23	23	WHEREAS, The General Assembly enacted Chapter 12.4 of Title 42 entitled “The 1
24	24	Rhode Island Medicaid Reform Act of 2008”; and 2
25	25	WHEREAS, A legislative enactment is required pursuant to Rhode Island General Laws 3
26	26	chapter 12.4 of title 42, et seq.; and 4
27	27	WHEREAS, Rhode Island General Laws § 42-7.2-5(3)(i) provides that the secretary of 5
28	28	the executive office of health and human services is responsible for the review and coordination 6
29	29	of any Medicaid section 1115 demonstration waiver requests and renewals as well as any 7
30	30	initiatives and proposals requiring amendments to the Medicaid state plan or category II or III 8
31	31	changes as described in the demonstration, “with potential to affect the scope, amount, or 9
32	32	duration of publicly-funded health care services, provider payments or reimbursements, or access 10
33	33	to or the availability of benefits and services provided by Rhode Island general and public laws”; 11
34	34	and 12
35	35	WHEREAS, In pursuit of a more cost-effective consumer choice system of care that is 13
36	36	fiscally sound and sustainable, the secretary requests legislative approval of the following 14
37	37	proposals to amend the demonstration; and 15
38	38	WHEREAS, Implementation of adjustments may require amendments to the Rhode 16
39	39	Island’s Medicaid state plan and/or section 1115 waiver under the terms and conditions of the 17
40	40	demonstration. Further, adoption of new or amended rules, regulations and procedures may also 18
41	41	be required: 19
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45	45	(1) Nursing facility rate increase alignment with state revenue growth. The executive 1
46	46	office of health and human services will pursue and implement any state plan amendments 2
47	47	needed to limit rate increases for nursing facilities in Fiscal Year 2025-2026 to the anticipated 3
48	48	rate of growth of state tax revenue, estimated to be 2.3 percent. 4
49	49	(2) Inpatient and outpatient hospital rate increase alignment with state revenue growth. 5
50	50	The executive office of health and human services will pursue and implement any state plan 6
51	51	amendments needed to limit rate increases for inpatient and outpatient hospital services in Fiscal 7
52	52	Year 2025-2026 to the anticipated rate of growth of state tax revenue, estimated to be 2.3 percent. 8
53	53	(3) Home care rates. The secretary of the executive office of health and human services 9
54	54	will pursue and implement any state plan amendments needed to eliminate annual rate increases 10
55	55	for home care services. 11
56	56	(4) Elimination of inpatient and outpatient hospital upper payment limit payments. The 12
57	57	secretary of the executive office of health and human services will pursue and implement any 13
58	58	state plan amendments needed to eliminate inpatient and outpatient hospital upper payment limit 14
59	59	payments. 15
60	60	(5) Establishment of interprofessional consultation program. The secretary of the 16
61	61	executive office of health and human services will pursue and implement any state plan 17
62	62	amendments needed to establish an interprofessional consultation program in Medicaid effective 18
63	63	October 1, 2025. 19
64	64	(6) Federal financing opportunities. The executive office health and human services 20
65	65	proposes that it shall review Medicaid requirements and opportunities under the U.S. Patient 21
66	66	Protection and Affordable Care Act of 2010 (PPACA) and various other recently enacted federal 22
67	67	laws and pursue any changes in the Rhode Island Medicaid program that promote, increase and 23
68	68	enhance service quality, access and cost-effectiveness that may require a Medicaid state plan 24
69	69	amendment or amendment under the terms and conditions of Rhode Island’s section 1115 waiver, 25
70	70	its successor, or any extension thereof. Any such actions by the executive office of health and 26
71	71	human services shall not have an adverse impact on beneficiaries or cause there to be an increase 27
72	72	in expenditures beyond the amount appropriated for Fiscal Year 2024-2025. 28
73	73	(7) Hospital state directed managed care payment. The secretary of the executive office is 29
74	74	hereby authorized and directed to amend its regulations for reimbursement to Medicaid Managed 30
75	75	Care Organizations and authorized to direct MMCOs to make quarterly state directed payments to 31
76	76	hospitals for inpatient and outpatient services in accordance with the payment methodology 32
77	77	contained in the approved Centers for Medicare and Medicaid services preprint for hospital state 33
78	78	directed payments. The total amount of these payments for Fiscal Year 2025-2026 shall be $396 34
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82	82	million; now, therefore, be it 1
83	83	RESOLVED, That the General Assembly hereby approves the above-referenced 2
84	84	proposals; and be it further 3
85	85	RESOLVED, That the secretary of the executive office of health and human services is 4
86	86	authorized to pursue and implement any waiver amendments, state plan amendments, and/or 5
87	87	changes to the applicable department’s rules, regulations and procedures approved herein and as 6
88	88	authorized by Rhode Island general laws chapter 12.4 of title 42; and be it further 7
89	89	RESOLVED, that this Joint Resolution shall take effect on July 1, 2025. 8
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96	96	EXPLANATION
97	97	BY THE LEGISLATIVE COUNCIL
98	98	OF
99	99	J O I N T R E S O L U T I O N
100	100	TO AMEND THE MEDICAID SECTION 1115 DEMONSTRATION WAIVER REQU ESTS
101	101	AND RENEWALS – RHODE ISLAND MEDICAID REFORM ACT OF 2008
102	102	***
103	103	This joint resolution would approve an amendment to the Medicaid section 1115 1
104	104	demonstration waiver requests and renewals. 2
105	105	This joint resolution would take effect on July 1, 2025. 3
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