Bills affecting Medicaid / public insurance in Rhode Island (2026 session)

Adds to those persons exempt from payment of parking fees at any recreational facility owned and operated by the state those individuals determined by the executive office of HHS, or its designee, to be disabled for purposes of Medicaid eligibility.

Provides that services provided by graduate student interns who work under a supervisory protocol would be eligible to be paid from Medicaid reimbursement.

Creates a publicly funded program for uninsured individuals requiring on an appropriation of $53,200,000 for fiscal year 2027 and an appropriation of 109,600,000 for fiscal year 2028 and every fiscal year thereafter.

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.

Adds property damage to statutory underinsured motor coverage, rather than just uninsured motorist coverage, as it is presently.

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 a universal and unified healthcare system and reform the current payment system for healthcare coverage in this state.

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.

Provides for mandatory uninsured motorist coverage.

Provides that a student's enrollment in Medicaid would be included in calculating and determining the student success factor for use in the foundation education-aid formula.

Requires that reimbursement rates for certified mobile response and stabilization services be equal to or greater than the prevailing integrated state Medicaid rate for mobile response and stabilizations services

Sets controls on Medicaid prescription drug costs by imposing transparency and accountability requirements on managed care organizations (MCOs) and their pharmacy benefit managers (PBMs).

Requires the EOHHS to amend the state Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical pediatric services.

Requires Rhode Island Medicaid to cover services provided by licensed certified professional midwives and to collect utilization and cost data, while allowing limits consistent with Medicaid rules.

Requires Medicaid to cover services by licensed certified lactation counselors and EOHHS to oversee and implement the program and track related costs and use. It also ensures reimbursement consistent with similar providers.

Expands the patient-centered medical home program to all Medicaid-accepting independent primary care practices and nurse practitioners and increases reimbursement rates to match Massachusetts and Connecticut rates.

Establishes a fund to support children’s community-based providers’ infrastructure changes necessary and related to the state’s Medicaid transformation initiative.

Provides proper authority for the division of taxation to provide HSRI with contact information for Rhode Islanders who report they were uninsured on their RI state income tax return.

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.

Requires Medicaid to provide coverage for fertility medication, care, and services, for at least 3 cycles of fertility treatment, and intrauterine insemination.