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H8561
2026 -- H 8561
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LC006445
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- MEDICAID PROGRAM
FUNDING AND REALLOCATION OF ENROLLMENT SAVINGS
Introduced By:
Representatives Solomon, and Casey
Date Introduced:
May 15, 2026
Referred To:
House Finance
It is enacted by the General Assembly as follows:
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Section 1. Legislative findings.
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The general assembly finds and declares that:
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(1) The General Assembly recognizes the importance of maintaining access to healthcare
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services for Rhode Islanders and supporting a stable, functioning healthcare delivery system;
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(2) Recent and anticipated federal policy changes are expected to reduce Medicaid
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enrollment, resulting in a loss of coverage for thousands of Rhode Islanders;
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(3) The loss of insurance coverage does not eliminate the need for healthcare services, but
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shifts the cost of delivery of care to providers serving all patients regardless of ability to pay;
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(4) Hospitals, community health centers, and other providers will continue to deliver
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necessary care, resulting in increased uncompensated care and financial pressure on the healthcare
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system;
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(5) Reductions in Medicaid enrollment are expected to generate savings within the
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Medicaid program;
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(6) Aligning those savings with the continued demand for care supports provider stability
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and access to services across the state; and
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(7) Accordingly, any Medicaid program savings associated with enrollment reductions
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shall be retained within the healthcare system and reinvested in providers through targeted increases
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in reimbursement.
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SECTION 2. Title 42 of the General Laws entitled "STATE AFFAIRS AND
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GOVERNMENT" is hereby amended by adding thereto the following chapter:
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CHAPTER 169
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MEDICAID PROGRAM FUNDING AND REALLOCATION OF ENROLLMENT SAVINGS
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42-169-1. Definitions.
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As used in this chapter, “enrollment-driven savings” means the reduction in Medicaid
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expenditures in the fiscal year ending June 30, 2028, attributable to decreases in enrollment, as
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reflected in the estimates adopted at the May meeting of the Rhode Island caseload estimating
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conference.
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42-169-2. Reallocation of savings.
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Notwithstanding any general or special law to the contrary:
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(1) All enrollment-driven savings shall be retained within the Medicaid program and shall
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not be used for deficit reduction or other purposes;
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(2) Such savings shall be reallocated exclusively to increase Medicaid provider
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reimbursement rates, including:
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(i) Hospital inpatient services;
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(ii) Hospital outpatient services;
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(iii) Physician services; and
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(iv) Federally qualified health center services; and
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(3) Funds provided pursuant to this section shall be additive to existing Medicaid
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reimbursement levels and shall not be used to supplant, replace, or offset existing appropriations,
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rate structures, or payment methodologies in effect as of June 30, 2026.
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42-169-3. Implementation.
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The executive office of health and human services shall:
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(1) Adjust Medicaid fee-for-service reimbursement rates as necessary;
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(2) Amend managed care contracts and/or implement state directed payments to ensure that
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rate increases are reflected in payments to providers, with a minimum provider pass-through rate
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of not less than ninety percent (90%) of each rate increase, implemented within one hundred eighty
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(180) days of the effective date of each rate adjustment; and
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(3) Submit any required state plan amendments, waivers, or federal approvals to the
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Centers for Medicare & Medicaid Services.
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42-169-4. Reporting and compliance.
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The executive office of health and human services shall submit an annual report to the
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general assembly no later than October 31 of each year, covering the following:
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(1) The calculation of enrollment-driven savings, including the methodology and actuarial
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assumptions used;
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(2) Provider rate adjustments implemented pursuant to this chapter, itemized by provider
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type and care setting;
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(3) The total amount of federal financial participation generated by rate investments made
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under this chapter;
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(4) The status of any required state plan amendments, waivers, or federal approvals,
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including any approvals pending or denied by the Centers for Medicare & Medicaid Services; and
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(5) Compliance by managed care organizations with the provider pass-through payment
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requirements established under § 42-169-3(2).
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SECTION 3. This act shall take effect on July 1, 2026.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- MEDICAID PROGRAM
FUNDING AND REALLOCATION OF ENROLLMENT SAVINGS
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This act would provide that any Medicaid program savings associated with enrollment
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reductions would be retained within the healthcare system and reinvested in providers through
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targeted increases in reimbursement.
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This act would take effect on July 1, 2026.
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