JOINT RESOLUTION TO AMEND THE MEDICAID SECTION 1115 DEMONSTRATION WAIVER REQUESTS AND RENEWALS (Allows EOHHS to implement waiver amendments, state plan amendments, and changes to department rules and regulations to make certain updates to the behavioral health per-diem add on program for particularly complex patients.)

Plain-English Summary

This bill is a joint resolution that would give Rhode Island's Executive Office of Health and Human Services (EOHHS) the authority to make specific updates to how the state's Medicaid program handles care for people with serious and complex behavioral health needs. In particular, it focuses on a program that provides extra daily funding — called a "per-diem add-on" — to healthcare providers who treat patients with especially complicated behavioral health conditions. The bill would allow the state to formally request changes to federal Medicaid rules and update its own regulations to reflect these updates.

To make changes to Medicaid in Rhode Island, the state must sometimes get approval from the federal government through a process involving special waivers and plan amendments. This bill authorizes EOHHS to pursue those federal approvals and adjust relevant state rules as needed. Essentially, the legislature would be giving EOHHS the green light to move forward with these specific updates without needing to return for separate approval on each individual change.

The people most directly affected would be Medicaid patients with complex behavioral health needs — such as those dealing with serious mental illness or substance use disorders — as well as the hospitals, clinics, and other providers who care for them. The goal appears to be refining how these providers are compensated for treating some of the most challenging cases. Currently, the bill has been referred to the Senate Health and Human Services Committee and is being held for further study.