The bill amends Section 40-8-26 of the General Laws in Chapter 40-8, which pertains to "Medical Assistance," specifically focusing on community health centers. It requires that reimbursement for medical, dental, and behavioral health services provided at community health centers equal the lesser of the actual cost, based on Medicaid cost reports, or one hundred twenty-five percent (125%) of the median rate for all community health centers within Rhode Island. The bill defines community health centers as federally qualified health centers and rural health centers. It allows the executive office of health and human services to adopt an alternative payment methodology (APM) for Medicaid reimbursement, aimed at ensuring high-quality care. For centers that do not agree to the APM principles, reimbursement will occur at the federal prospective payment system (PPS) rate, as mandated by federal law. The act emphasizes the need for community health centers to comply with reporting requirements and outlines the process for incorporating reimbursement rates into monthly payments and capitation rates for health plans. This act will take effect upon passage.

Statutes affected:
896: 40-8-26