Provides the state would cover dialysis for the treatment of end stage renal disease ("ESRD") and kidney transplants for persons who do not qualify for full Medicaid due to their immigration status.
Provides that the EOHHS, through Emergency Medicaid, cover dialysis for the treatment of end stage renal disease ("ESRD") and kidney transplants for RI residents who do not qualify for full Medicaid under federal law due to their immigration status.
Provides that licensed independent clinical social workers be able to enroll and bill Medicaid directly for covered services provided to adults with Medicaid fee-for-service coverage.
HB 7274 allows physician assistants (PAs) to practice without needing a physician's direct supervision and permits them to receive Medicaid payments directly for services provided. The bill amends licensing rules to remove the requirement for written agreements with supervising physicians and clarifies that PAs can provide medical services within their scope without physician oversight. It also adds a new provision requiring Medicaid to pay PAs directly, rather than through a physician's billing, for services rendered. This affects PAs by expanding their practice autonomy and Medicaid patients by potentially increasing access to care from PAs. The changes take effect upon passage.
SB 2109 prohibits health insurers and pharmacy benefit managers from requiring or conducting insurance reviews for prescriptions used to treat opioid or alcohol use disorder. Specifically, it blocks reviews for medications containing methadone, buprenorphine, or naltrexone, or for any FDA-approved medication managing opioid withdrawal. The bill directly affects patients seeking addiction treatment and insurers/pharmacy managers handling these prescriptions. It also requires Medicaid managed care organizations to use state-set medical necessity criteria for reviews. The law takes effect upon passage.
Provides that licensed independent clinical social workers be able to enroll and bill Medicaid directly for covered services provided to adults with Medicaid fee-for-service coverage.
Prohibits insurance companies from paying a rate that is less than the approved Medicaid rate set by the executive office of health and human services.
Establishes the Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers.
SR 2257 is a Senate Resolution requesting Rhode Island's Executive Office of Health and Human Services (EOHHS) to adopt an electronic Preadmission Screening and Resident Review (PASRR) system by January 1, 2027. This system is required by federal law to screen individuals with serious mental illness or intellectual/developmental disabilities before nursing home admission, directly affecting Medicaid-certified nursing facilities and vulnerable residents. The resolution asks EOHHS to investigate cost savings, potential partnerships with neighboring states, and federal funding to implement the digital system, which aims to reduce unnecessary institutionalization and support community-based care options. (Note: As a procedural resolution, this is a request to the executive branch, not a law requiring immediate action.)
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
