2014 -- S 2533

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LC004733

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO HEALTH AND SAFETY - THE RHODE ISLAND HEALTHCARE

AUTHORITY

     Introduced By: Senators Goldin, Nesselbush, Cool Rumsey, Conley, and Miller

     Date Introduced: February 27, 2014

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

amended by adding thereto the following chapter:

CHAPTER 93

THE RHODE ISLAND HEALTH CARE AUTHORITY

     23-93-1. Declaration of state policy. -- It is hereby declared to be the official state

policy to adopt an active purchaser health insurance and health services model which aggregates

all funding of such insurance and services, including, but not limited to, private insurance,

Medicaid, and Medicare, through HealthSource RI or its successor agency.

     23-93-2. Rhode Island health care authority established. -- (a) There is hereby

established an independent authority to be known as the Rhode Island healthcare authority,

sometimes referred to herein this chapter as “the authority.” The authority shall be operated under

the leadership of an appointed health care commissioner.

     (b) The governor shall appoint the health care commissioner with the advise and consent

of the senate. The health care commissioner shall chair the Rhode Island health care authority.

The governor shall make the appointment on an interim basis if necessary until the senate is in

session. The executive department shall provide any staff, space, and funding necessary for the

authority to accomplish its mandate.

     (c) The Rhode Island health care authority shall consist of:

     (1) The speaker of the house or designee;

     (2) The senate president or designee;

     (3) Two (2) health care consumers;

     (4) One chief executive officer of a hospital, nominated from among the hospitals in

Rhode Island;

     (5) One physician nominated from among the primary care specialty societies in Rhode

Island;

     (6) One nurse or allied professional nominated from among nursing organizations in

Rhode Island;

     (7) One chief executive officer of a health insurance company nominated from among the

Rhode Island companies;

     (8) One representative of a labor union;

     (9) One Representative of small business nominated from among Rhode Island small

businesses;

     (10) One representative of large business nominated from among Rhode Island large

businesses;

     (11) One representative of behavioral health provider nominated from the community

mental health providers;

     (12) Two (2) health policy experts; and

     (13) The secretary of the executive office of health and human services.

     23-93-3. Report from authority. -- (a) On or before January 2, 2016, and annually

thereafter, the health care authority shall provide to the general assembly and the governor of the

state of Rhode Island a report of all recommended legislative and/or regulatory actions that would

be required to:

     (1) Present a state innovation waiver (SIW) to the federal government on behalf of the

state;

     (2) Make HealthSourceRI the sole hub for securing insurance or health services coverage

for all Rhode Island residents;

     (3) Aggregate all state, federal, and private medical funding for health insurance and/or

health care services including, but not limited to, Medicaid, Medicare, and self-insured plans

through HealthSourceRI or its successor entity;

     (4) Provide alternatives to employer-based funding of private insurance that explicitly

dissociates private insurance funding from employment status and provides possible alternative to

funding of health insurance, one of which shall be funding through the payroll tax, inter alia;

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     (5) Promote the merger of all state agency functions which currently regulate insurance

or fund or provide health services into one health care authority, including, but not limited to, all

or part of the executive office of health and human services (EOHHS), the office of the health

insurance commissioner (OHIC), HealthSourceRI, the department of human services (DHS), the

department of health (DOH), the department of behavioral healthcare, developmental disabilities

and hospitals (BHDDH), and the department of administration (DOA), inter alia;

     (6) Establish an annual global spending target for all health care expenditures in the state

based on CMS market basket or comparable benchmark, with explicit enforcement of compliance

by health care providers;

     (7) Incrementally shift one hundred percent (100%) of all hospital revenue received from

a fee-for-service model to a global payment model over five (5) years;

     (8) Establish a standard set of benefits to meet the health care needs of Rhode Island

residents; and

     (9) Fund and staff the coordinated health planning and affordability council and charge it

to develop a comprehensive five (5) year state population health improvement plan. The goal of

the plan shall be to drive excellence in population health management and serve as the foundation

for a health care system that is affordable, accessible, and delivers high quality outcomes and

health promotion services in order to pursue the complete physical, mental and social well-being

of Rhode Islanders. The state population health improvement plan shall provide direction to the

health care authority and shall be developed every five (5) years.

     (b) Annual reports submitted by the authority subsequent to the initial report shall

provide an update as to the above points, and with particular emphasis on the progress the state is

making in regard to adopting and implementing an active purchaser health insurance and health

services model which aggregates all funding of such insurance and services, including, but not

limited to, private insurance, Medicaid, and Medicare, through HealthSourceRI or its successor

agency.

     23-93-4. Plans not to be limited. -- Nothing in this chapter shall be construed to limit the

choice and number of plans provided for the consumers.

     23-93-5. Severability. -- If any provision of this chapter or the application of this chapter

to any person or circumstances is held invalid, the invalidity shall not affect other provisions or

applications of the chapter which can be given effect without the invalid provision or application,

and to this end the provisions of this chapter are declared to be severable.  

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - THE RHODE ISLAND HEALTHCARE

AUTHORITY

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     This act would establish the Rhode Island healthcare authority. The authority would be

charged with overseeing that the state adopt and implement an active purchaser health insurance

and health services model which aggregates all funding of such insurance and services, including,

but not limited to, private insurance, Medicaid, and Medicare, through HealthSource RI or its

successor agency.

     This act would take effect upon passage.

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