=======

art.017/1

=======

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

 

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.

 

Art17
RELATING TO MEDICAID REFORM ACT OF 2008 RESOLUTION
(Page 2 of 2)