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HB 7693

AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR CHILDREN AND PREGNANT WOMEN

2026 Regular Session Introduced by Edith Ajello and 9 co-sponsors

Rhode Island would raise Medicaid outpatient pediatric payment rates to 130% of Medicare by Oct 1, 2026 to attract and retain pediatric providers and expand access.

05/05/2026 Committee recommended measure be held for further study
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Bill Summary · HB 7693

Summary of HB 7693 (Rhode Island, 2026)

Title

AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT — HEALTH CARE FOR CHILDREN AND PREGNANT WOMEN

Purpose and Intent

The bill aims to address Rhode Island’s pediatric health care workforce crisis by increasing Medicaid payment rates for outpatient pediatric services to attract, recruit, and retain pediatricians, subspecialists, child psychiatrists, and related providers. The core goal is to improve access to pediatric care for children under 19 by enabling providers to manage current patient panels more effectively and to offset anticipated retirements and workforce shortages.

Key Provisions

  • Medicaid payment rate increase: Requires the executive office of health and human services (EOHH S) to pursue a Medicaid state plan amendment and allocate sufficient state general revenue to raise Medicaid payment rates for outpatient clinical services to 130% of Medicare rates for all payment codes for patients under 19 years old.

  • Effective date: The rate increase must be in place on or before October 1, 2026.

  • Scope of services and providers: The higher reimbursement rates would apply to outpatient pediatric services and are intended to support a broad range of pediatric care providers, including:

    • Pediatricians
    • Pediatric subspecialists
    • Child psychiatrists
    • Family medicine physicians
    • Nurse practitioners
    • Physician assistants

  • Rationale and findings: The bill articulates several findings:

    • Rhode Island faces a pediatric workforce crisis with access to care declines.
    • A 2024 survey showed many pediatric practices are not accepting new patients, and a substantial portion plan to retire soon.
    • Medicaid payment rates for pediatric specialists are comparatively low, affecting recruitment.
    • Medicaid coverage is a significant payer for children and directly influences access to care.
    • Improving childhood health care has long-term cost and health benefits.

Affected Parties and Impacts

  • Children and pregnant women: Indirectly benefited through improved access to pediatric and related health services, as providers may expand capacity and recruitment due to better reimbursement.

  • Pediatric providers and facilities: Likely to experience improved financial viability, enabling recruitment and retention of staff (pediatricians, subspecialists, child psychiatrists, family physicians, NPs, PAs) and potential expansion of pediatric panels.

  • Rhode Island Medicaid program: Changes require pursuing a state plan amendment and adjusting reimbursement rates, with corresponding state general revenue allocations to fund the increase.

  • State health policy and budget: Requires planning and allocation of resources to support higher Medicaid payments, with implications for fiscal planning and potential budget adjustments.

Procedural and Timeline Details

  • Legislative process: Referred to House Finance upon introduction.
  • Hearing/consideration: Scheduled for May 5, 2026 (per action history).
  • Effective date: Takes effect upon passage; however, the explicit implementation target for the rate increase is October 1, 2026.

Additional Notes

  • The bill is primarily a funding and reimbursement reform aimed at stabilizing and expanding the pediatric health care workforce in Rhode Island.
  • It emphasizes the link between Medicaid payment rates and access to pediatric care, aligning reimbursement with 130% of Medicare to be more competitive with neighboring states.

If you’d like, I can provide a side-by-side comparison with current Medicaid rates or a brief briefing for policymakers on potential fiscal impacts and implementation steps.

Compiled from official sources — confirm details with the bill’s official record.

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