The bill amends Section 40-8-26 of the General Laws in Chapter 40-8, which pertains to "Medical Assistance," by introducing new provisions related to community health centers. It defines community health centers as federally qualified health centers and rural health centers, and allows the executive office of health and human services to adopt an alternative payment methodology (APM) for Medicaid reimbursement. This APM must comply with the prospective payment system (PPS) established by federal law. The bill stipulates that community health centers that do not agree to the APM principles will be reimbursed at the federal PPS rate, while those that do will have their reimbursement rates determined based on reasonable costs and efficiency standards.

Key changes include the insertion of "behavioral" alongside medical and dental care in the reimbursement framework, and a shift in the reimbursement cap from "not exceed" to "equal the lesser of the actual cost or" 125% of the median rate for community health centers in Rhode Island. Additionally, the bill mandates that actual costs be based on Medicaid cost reports, and it requires community health centers to comply with reporting requirements set by the executive office. The act will take effect upon passage.

Statutes affected:
896: 40-8-26