The bill amends Section 40-8.9-9 of the General Laws to establish a long-term-care rebalancing system reform goal. It mandates that all Medicaid programs operated by the executive office of health and human services, its subordinate agencies, contractors, and all commercial lines within health insurance companies contracted with the Medicaid Program shall not reimburse home care providers, home nursing care providers, and hospice providers less than fee-for-service rates. The executive office is responsible for adopting rate percentage increases applicable to these services based on a rate review report conducted by the office of the health insurance commissioner.

The bill introduces provisions for rate modifiers to incentivize direct care workers to provide care during evenings, nights, weekends, and holidays, as well as for hard-to-serve Medicaid beneficiaries residing in low-density population communities. It also requires compliance with federal regulations regarding time and travel costs for direct care employees.

Additionally, the legislation establishes a ten percent enhancement rate for providers sending direct care employees to Medicaid beneficiaries in communities with a population density of under one thousand and a population size of under twenty-five thousand. The bill allows the Rhode Island Partnership for Home Care, with oversight from the executive office, to coordinate behavioral health training for licensed nurse assistants and homemakers delivering paraprofessional care services to Medicaid home care beneficiaries.

The act reduces administrative burdens on Medicaid-contracted home care providers by eliminating a statutory reporting requirement that is no longer relevant. It emphasizes a person-centered approach, promoting individual choice and access to supportive services in community settings, thereby reducing reliance on institutional care. The bill aims to enhance Medicaid long-term care services by establishing a statewide network for conflict-free case management, to be implemented by January 1, 2024, ensuring equitable access to person-centered planning and quality monitoring for individuals receiving Medicaid-funded services. The legislation also includes provisions for rate adjustments based on inflation and compliance with federal regulations, while deleting outdated language to streamline the bill's objectives. This act would take effect upon passage.

Statutes affected:
8218: 40-8.9-9