Rhode Island 2026 Regular Session

Rhode Island House Bill H7693

Introduced
2/11/26  

Caption

Requires the EOHHS to amend the state Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical pediatric services.

Impact

The bill targets existing laws regarding Medicaid payment structures for pediatric services. By setting a higher reimbursement rate, it intends to enhance the financial viability of pediatric practices, thus enabling them to recruit and retain qualified healthcare professionals. The proposed increase is positioned as a necessary intervention to counteract the impending wave of retirements among existing pediatricians and the insufficient supply of specialty care for children. If successful, this legislation may significantly reduce the existing barriers to access healthcare for children statewide.

Summary

House Bill H7693 mandates that the Executive Office of Health and Human Services (EOHHS) amend Rhode Island's Medicaid plan to increase payment rates for outpatient clinical pediatric services to 130% of Medicare rates. This legislation seeks to address the critical pediatric healthcare provider shortage in the state and improve access to healthcare for children under 19 years old, as inadequate reimbursement rates have been a significant barrier to providing necessary care. The bill acknowledges the ongoing workforce crisis faced by pediatricians and aims to ensure that adequate pediatric services can be sustained in the state.

Contention

Debate surrounding H7693 may center on the long-term financial implications for the state budget as increasing Medicaid payment rates will require securing sufficient state general revenue. Opponents may raise concerns regarding the prioritization of funds, especially amid other pressing healthcare and social needs. Additionally, there might be discussions about whether the proposed rates align effectively with real costs of care or if there are alternative approaches to solve the healthcare provider shortage. The bill also highlights the ongoing disparities in Medicaid payment rates compared to neighboring states, raising questions about how the state can become more competitive in attracting healthcare providers.

Companion Bills

No companion bills found.

Previously Filed As

RI S0427

Requires the EOHHS to amend the state Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical pediatric services.

RI H5988

Requires the EOHHS to amend the state Medicaid plan and secure sufficient state general revenue to increase Medicaid payment rates to an amount equal to one hundred thirty percent (130%) of Medicare rates for outpatient clinical pediatric services.

RI S0793

Increases individual, group, and Medicaid insurance rates of reimbursement for ambulance and wheelchair van services to be equal to reimbursement rates provided by Medicare for the same medical services.

RI H5772

Increases individual, group, and Medicaid insurance rates of reimbursement for ambulance and wheelchair van services to be equal to reimbursement rates provided by Medicare for the same medical services.

RI H6373

Requires the executive office of health and human services to increase Medicaid payment rates for primary care services furnished by primary care providers to be commensurate with Medicare rates.

RI S1004

Requires the executive office of health and human services to apply to the Centers for Medicare and Medicaid Services for a state plan amendment for reimbursement for health services in a school.

RI H6308

Requires the executive office of health and human services to apply to the Centers for Medicare and Medicaid Services for a state plan amendment for reimbursement for health services in a school.

RI H6289

Raises the per diem rate by thirteen percent (13%) for Medicaid reimbursement for Tier C services provide by assisted living residence beginning January 1, 2026.

RI H6000

Requires all out-of-state foster care placement facilities be registered with Medicaid as a Medicaid provider.

RI H5986

Reduces the appropriation to Medicaid managed care in fiscal year 2025-2026 in order to increase the rates for Medicaid nursing facilities.

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