2020 -- H 7662 | |
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LC004978 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2020 | |
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A N A C T | |
RELATING TO THE STATE AFFAIRS AND GOVERNMENT - DEPARTMENT OF | |
HUMAN SERVICES | |
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Introduced By: Representative Joseph M. McNamara | |
Date Introduced: February 26, 2020 | |
Referred To: House Finance | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 42-12 of the General Laws entitled "Department of Human Services" |
2 | is hereby amended by adding thereto the following section: |
3 | 42-12-31. Medicaid primary care parity. |
4 | (a) This section is intended to ensure Rhode Island's children enrolled in Medicaid have |
5 | access to high-quality and coordinated medical care. In the face of a growing number of Rhode |
6 | Island children enrolled in Medicaid, this section shall address the many challenges related to |
7 | meeting the population health management targets required by the state of Rhode Island's |
8 | accountable entity program and the state's long-term vision of addressing Rhode Island's public |
9 | health challenges; which include, but are not limited to, high achievement in quality metric targets, |
10 | providing timely access to medical care, and reducing the overall costs of Rhode Island's Medicaid |
11 | program. To meet these objectives, the general assembly will encourage private community-based |
12 | pediatric primary care physicians to participate in Medicaid. |
13 | (b) To achieve the aforementioned objectives, private community-based pediatric primary |
14 | care physicians must be willing, and able, to open their practices (panels) to Medicaid beneficiaries. |
15 | (c) As a result of the 113th Congress, in which federal lawmakers failed to reauthorize the |
16 | Medicaid fee bump outlined in the Affordable Care Act, the federal government ended the two (2) |
17 | year Medicare fee parity program. In states that participated in Medicaid expansion, the Medicare |
18 | fee parity program incentivized private community-based pediatric primary care physicians to open |
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1 | their practices to Medicaid beneficiaries. The end of this program, and fee-forĀservices cuts of up |
2 | to fifty-five percent (55%), put significant financial pressure on Rhode Island's private community- |
3 | based pediatric primary care physicians. |
4 | Providers were forced to either close their practices to Medicaid beneficiaries, or to stop |
5 | caring for Medicaid patients. As the volume of Medicaid patients seeking care increases, getting |
6 | access to primary care is difficult for Rhode Island's Medicaid beneficiaries. As Medicaid |
7 | enrollment continues to increase, when currently more than one-in-four (4) Rhode Island residents |
8 | is a Medicaid beneficiary, the state is faced with an access crisis to primary care medicine. |
9 | (d) To ensure that Rhode Island's Medicaid beneficiaries are able to get access to high |
10 | quality and coordinated health care, effective July 1, 2021, the general assembly shall raise |
11 | Medicaid primary care payment rates to federal Medicare levels, paying private community-based |
12 | pediatric primary care providers one hundred percent (100%) of the federal Medicare fee-for- |
13 | service rates. Often referred to as "Medicaid primary care parity", this provision shall: |
14 | (1) Incentivize private community-based pediatric primary care physicians to participate |
15 | in the state's Medicaid program; |
16 | (2) Support the goals and objectives of the executive office of health and human services' |
17 | accountable entity program: |
18 | (3) Support Rhode Island's private community-based pediatric primary care providers; |
19 | (4) Support the ten (10) year public health vision shared by the Rhode Island department |
20 | of health in partnership with the Rhode Island Foundation; |
21 | (5) Support the office of the health insurance commissioner's affordability standards; and |
22 | (6) Ensure Medicaid beneficiaries get access to high quality and coordinated primary care. |
23 | 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 THE STATE AFFAIRS AND GOVERNMENT - DEPARTMENT OF | |
HUMAN SERVICES | |
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1 | This act would, on July 1, 2021, raise Medicaid primary care payment rates to federal |
2 | Medicare levels, which would result in paying private community-based pediatric primary care |
3 | providers one hundred percent (100%) of the federal Medicare fee-for-service rates. |
4 | This act would take effect upon passage. |
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