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art.017/1 | ||
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1 | ARTICLE 17 | |
2 | RELATING TO MEDICAID REFORM ACT OF 2008 RESOLUTION | |
3 | SECTION 1. Rhode Island Medicaid Reform Act of 2008 Resolution. | |
4 | WHEREAS, , the General Assembly enacted Chapter 12.4 of Title 42 entitled “The Rhode | |
5 | Island Medicaid Reform Act of 2008”; and | |
6 | WHEREAS, a legislative enactment is required pursuant to Rhode Island General Laws | |
7 | 42-12.4-1, et seq.; and | |
8 | WHEREAS, Rhode Island General Law 42-7.2-5(3)(a) provides that the Secretary of the | |
9 | Executive Office of Health and Human Services (“Executive Office”) is responsible for the review | |
10 | and coordination of any Rhode Island’s Medicaid section 1115 demonstration waiver requests and | |
11 | renewals as well as any initiatives and proposals requiring amendments to the Medicaid state plan | |
12 | or changes as described in the demonstration, “with potential to affect the scope, amount, or | |
13 | duration of publicly-funded health care services, provider payments or reimbursements, or access | |
14 | to or the availability of benefits and services provided by Rhode Island general and public laws”; | |
15 | and | |
16 | WHEREAS, in pursuit of a more cost-effective consumer choice system of care that is | |
17 | fiscally sound and sustainable, the Secretary of the Executive Office requests legislative approval | |
18 | of the following proposals to amend the Rhode Island’s Medicaid section 1115 demonstration: | |
19 | (a) Provider rates – Adjustments. The Executive Office proposes to: | |
20 | (i) reduce in-patient and out-patient hospital payment rates by maintaining state fiscal year | |
21 | 2019 levels; | |
22 | (ii) increase nursing home rates by one percent (1%) on October 1, 2019; | |
23 | (iii) establish, effective July 1, 2019, that the rate for hospice providers delivering hospice | |
24 | care in a skilled nursing facility will not exceed ninety-five percent (95%) of the rate paid for non- | |
25 | hospice care in a skilled nursing facility; and | |
26 | (iv) reduce the rates for Medicaid managed care plan. | |
27 | Implementation of adjustments may require amendments to the Rhode Island’s Medicaid | |
28 | state plan and/or section 1115 demonstration waiver under applicable terms and conditions. | |
29 | Further, adoption of new or amended rules, regulations and procedures may also be required. | |
30 | (b) Fiscal Intermediary for Self-Direction Programs. The Executive Office proposes | |
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1 | to seek a waiver of freedom of choice of providers under Title XIX of the Social Security Act, as | |
2 | amended, to utilize one fiscal intermediary for the Medicaid self-direction programs currently being | |
3 | implemented by the state. Authority for the waiver requires amendments to the Rhode Island’s | |
4 | Section 1115 demonstration waiver and may also necessitate the adoption of new or amended rules, | |
5 | regulations and procedures. | |
6 | (c) Expansion of Home and Community Care Co-Pay Program. The Executive Office, | |
7 | in conjunction with the Division of Elderly Affairs, proposes to implement the authorities approved | |
8 | under the section 1115 waiver demonstration to increase the maximum income limit for all co-pay | |
9 | program eligibility from two hundred percent (200%) of the Federal Poverty Level to two hundred | |
10 | and fifty percent (250%) of the Federal Poverty Level. Implementation of these waiver authorities | |
11 | requires adoption of new or amended rules, regulations and procedures. | |
12 | (d) Increase in the Department of Behavioral Healthcare, Developmental Disabilities | |
13 | and Hospitals (BHDDH) Direct Care Service Workers Wages. To further the long-term care system | |
14 | rebalancing goal of improving access to high quality services in the least restrictive setting, the | |
15 | Executive Office proposes to establish a targeted wage increase for certain community-based | |
16 | BHDDH developmental disability private providers and self-directed consumer direct care service | |
17 | workers. Implementation of the program may require amendments to the Medicaid State Plan | |
18 | and/or Section 1115 demonstration waiver due to changes in payment methodologies. | |
19 | (e) Federal Financing Opportunities. The Executive Office proposes to review | |
20 | Medicaid requirements and opportunities under the U.S. Patient Protection and Affordable Care | |
21 | Act of 2010, as amended, and various other recently enacted federal laws and pursue any changes | |
22 | in the Rhode Island Medicaid program that promote service quality, access and cost-effectiveness | |
23 | that may warrant a Medicaid state plan amendment or amendment under the terms and conditions | |
24 | of Rhode Island’s section 1115 waiver, its successor, or any extension thereof. Any such actions | |
25 | by the Executive Office shall not have an adverse impact on beneficiaries and shall not cause an | |
26 | increase in expenditures beyond the amount appropriated for state fiscal year 2020. | |
27 | Now, therefore, be it | |
28 | RESOLVED, the General Assembly hereby approves the proposals under paragraphs (a) | |
29 | through (e) above; and be it further; | |
30 | RESOLVED, the Secretary of the Executive Office is authorized to pursue and implement | |
31 | any Rhode Island’s Medicaid section 1115 demonstration waiver amendments, Medicaid state plan | |
32 | amendments, and/or changes to the applicable department’s rules, regulations and procedures | |
33 | approved herein and as authorized by 42-12.4; and be it further | |
34 | RESOLVED, that this Joint Resolution shall take effect upon passage. | |
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