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6/18/2024
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Rhode Island HEALTH Initiative bills approved in General Assembly
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 STATE HOUSE – Legislation included in the Rhode Island HEALTH Initiative (Holistic Enhancement and Access Legislation for Total Health), which was unveiled by Senate leaders earlier this year to improve health care access and affordability in Rhode Island, has been approved in the General Assembly and will be sent to the Governor for consideration.
The initiative was announced in March by Senate President Dominick J. Ruggerio; Senate Majority Leader Ryan W. Pearson; Senate Health & Human Services Committee Chairman Joshua Miller; Senate Environment & Agriculture Committee Chairwoman Alana M. DiMario, who works as a licensed mental health counselor in private practice; and Senate Health & Human Services Committee Secretary Pamela J. Lauria, who works as a primary care nurse practitioner.
“Few issues are as important as health care, and right now, our health care system is in critical condition. Health care absolutely must be accessible and affordable for all Rhode Islanders. But for too many people in our state, care is too expensive or too difficult to get. And we know that many health care providers are feeling enormous strain due to many factors. Like providers and consumers, our community hospitals, including Fatima in my district, are facing difficult circumstances,” said President Ruggerio (D-Dist. 4, North Providence, Providence). “I want to recognize the outstanding work of my colleagues in the Senate in the development of this package of bills, and thank our many other partners, including many vital stakeholders, for working collaboratively with us on these issues. As we celebrate our victories in the 2024 session, we are committed to continuing our work on this issue and accomplishing all the objectives of the HEALTH Initiative.”
“We are very fortunate in the Senate to have such a knowledgeable and dedicated membership committed to addressing the challenges facing our state. When we approached the development of this package of bills, we wanted to take a holistic approach to addressing the many intertwined factors that impact the health care system. These bills – the Rhode Island HEALTH Initiative – are taking important steps that, taken together, will have a real impact at improving the health of our health care system, containing costs for providers and consumers, and improving access to care,” said Leader Pearson (D-Dist. 19, Cumberland, Lincoln).
CONSUMER PROTECTION
“As a licensed mental health counselor, I am closely connected to the struggles of patients as they navigate so many facets of their lives. But for too many, simply trying to navigate our health care system only adds to their struggle. It’s more than just the cost – it’s the obstacles they too often face in terms transparency and predictability. That’s why we focused on consumer protections as a pillar of this initiative,” said Chairwoman DiMario (D-Dist. 36, North Kingstown, Narragansett, New Shoreham).
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Hospital determination of Medicare & Medicaid eligibility for uninsured patients (Sponsored by Sen. Lauria, 2024-S 2714Aaa): This legislation would require all hospitals to screen uninsured patients for Medicaid, Medicare, and other financial assistance programs. It would require hospitals to hold all invoices/claims until 30 days after discharge for the purposes of application review and determination. It additionally establishes a complaint process at EOHHS for complaints and violations. The Attorney General is empowered to bring legal action against the hospital and can permit a corrective action plan in lieu of legal action. (This legislation passed the General Assembly and will be sent to the Governor)
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State purchase of medical debt through ARPA funding (Sponsored by Sen. Mark McKenney, 2024-S 2712Aaa): This measure uses federal American Rescue Plan Act funds to purchase medical debt for pennies on the dollar, and then eliminate that debt for eligible Rhode Islanders. To be eligible, residents would need to have outstanding medical debt that equals 5% or more of their annual income and more than $600 of debt or have a household that is no more than 400% of the federal poverty line. The elimination of debt in this manner has been done in Connecticut, New York City, and Cook County, Illinois. (This legislation was incorporated into the FY25 state budget, which has been signed by the Governor and is now law)
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Prohibition on medical debt reporting to credit bureaus (Sponsored by Sen. Melissa Murray, 2024-S 2709A): This bill would prohibit debt collectors from reporting all medical debt to credit bureaus. It also sets rules for communication with consumers, false and misleading representation by debt collectors, and a prohibition against collections during insurance appeals. (This legislation passed the General Assembly and will be sent to the Governor)
PROVIDER AVAILABILITY & CARE QUALITY
“Over the years in my work as a primary care nurse practitioner, it has become increasingly clear the many ways in which our health care system is struggling. A shortage of providers across all facets of the health system is an especially urgent concern, and while that starts with primary care, it extends to nurses, specialists, counselors, and beyond. One of the pillars of the Rhode Island HEALTH initiative seeks to address the issue of provider availability, because to truly ensure everyone has access to quality care, we must have enough providers to meet our needs,” said Senator Lauria (D-Dist. 32, Barrington, Bristol, East Providence).
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Enhanced Curriculum & Clinical Training (Sponsored by Sen. Lauria, 2024-S 2716A): This measure provides $2.7 million to primary care practices to serve as enhanced interdisciplinary clinical training sites. It will recruit 30 advanced primary care training sites, increasing training slots by 50% for nurse practitioners, physician assistant students, and physician residents. The funds will also be used to develop a site curriculum, quarterly learning collaborative sessions, data collection, and project management. These sites are needed to train the next generation of providers, and since students often decide to work where they train, increasing training can improve access to care. (This legislation was incorporated into the FY25 state budget, which has been signed by the Governor and is now law)
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Primary Care Scholarship Program (Sponsored by Sen. Lauria, 2024-S 2717A): This measure was included as part of the Wavemaker Scholarship Program, which provides a tax credit to cover the cost of student loans. It funds a 4-year scholarship program for primary care physicians, nurse practitioners, and physician’s assistants. The students would either remain in Rhode Island after medical school or return to Rhode Island after residency training in Family Medicine, Pediatrics, or General Internal Medicine to practice primary care for 8 years. The goals are to encourage medical students to practice in these fields due to the reduction or elimination of their student debt. (Wavemaker Scholarship Program legislation passed by the Senate was incorporated into the FY25 state budget, which has been signed by the Governor and is now law)
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Social Work Interstate Licensure Compact (Sponsored by Sen. DiMario, 2024-S 2184A): This legislation would make Rhode Island one of the founding states in the compact, able to participate in rulemaking to establish the interstate licensure credential for social workers. It will provide increased access to mental health support for Rhode Island residents and increased work options for Rhode Island social workers. (This legislation passed the General Assembly and will be sent to the Governor)
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Counseling Compact (Sponsored by Sen. Matthew LaMountain, 2024-S 2183): This legislation would adopt an existing compact, providing increased access to mental health support for state residents and increased work options for Rhode Island social workers. (This legislation passed the General Assembly and will be sent to the Governor)
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Audiology Compact (Sponsored by Senate President Pro Tempore Hanna Gallo, 2024-S 2173): This legislation would adopt the Audiology and Speech-Language Pathology Interstate Compact and establish a commission to administer the provisions in the compact between the states. (This legislation passed the General Assembly and will be sent to the Governor)
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Occupational Therapy Compact (Sponsored by Sen. Miller, 2024-S 2623A): This legislation would adopt the Occupational Therapy Licensure Compact, which has been adopted by 30 other states. This compact will become operational in the second half of 2024. (This legislation passed the General Assembly and will be sent to the Governor)
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NCLEX pending exemption (Sponsored by Senate Majority Whip Valarie Lawson, 2024-S 2083): This legislation would allow for a nurse to be exempt from certain licensing requirements to practice before taking and receiving results from the NCLEX, the licensing examine developed by the National Council of State Boards of Nursing. (This legislation passed the General Assembly and will be sent to the Governor)
COST CONTAINMENT
“Health care is an extremely complex policy area. The details can be daunting, and consensus can be difficult to reach. I am grateful to Senate leadership, the members of the Health & Human Services Committee, the staff members and stakeholders who support and inform our work, and my colleagues for their efforts to advance this initiative. We have made cost containment a priority because it’s no secret that inflation has placed financial strain on Rhode Islanders, and increasing medical costs are not sustainable for our state’s working families,” said Chairman Miller (D-Dist. 28, Cranston, Providence).
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Price transparency (Sponsored by Senate Minority Leader Jessica de la Cruz, 2024-S 2078): This legislation would codify Centers for Medicare & Medicaid Services rules that require hospitals to publish pricing information in two formats: a consumer-friendly list of 300 “shoppable services,” and a comprehensive machine-readable file for all items and services. Placing this sunshine requirement into statute will help people understand and reduce costs. (This legislation passed the General Assembly and will be sent to the Governor)
For more information, contact:
Daniel Kittredge, Deputy Directory of Communications
State House Room 112
Providence, RI 02903
(401) 276-5516
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