The proposed bill, titled the "Rhode Island Medicaid Eligibility Determination Act," aims to amend Title 40 of the General Laws concerning human services by establishing a new chapter dedicated to Medicaid eligibility determination. It specifies that eligibility for Medicaid benefits in Rhode Island must be determined exclusively using state-controlled data sources, including SWICA and PARIS data, while explicitly prohibiting the use of private entity data in any part of the eligibility determination process.

Additionally, the bill mandates that any individuals terminated from Medicaid utilizing private entity data prior to the act's effective date must be retroactively reinstated within ten days, unless the executive office of health and human services determines that the termination was correct using only state data sources within that timeframe. If the termination is deemed correct, individuals will have the right to appeal the decision without a time limit.

Furthermore, the bill emphasizes that all Medicaid termination decisions must be made by human employees of the executive office of health and human services or the department of human services, thereby banning automated terminations. It stipulates that if an employee has made more than fifty termination decisions on the day of a specific termination, that decision will not be valid. The legislation also places the burden of proof on the state to demonstrate that any termination recommended by a computer program was independently reviewed by an employee. This act is set to take effect upon passage.