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HB 8500

AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND HUMAN SERVICES

2026 Regular Session Introduced by Jennifer Boylan and 9 co-sponsors

The bill requires quarterly financial reporting by major health care providers to the state, enabling early risk detection and corrective actions to protect public health funding.

05/28/2026 Committee recommended measure be held for further study
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Bill Summary · HB 8500

Bill Summary: HB 8500 (Rhode Island, 2026)

Title

AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND HUMAN SERVICES

Purpose and Intent

  • To promote fiscal integrity, transparency, and accountability within Rhode Island’s health and human services system.
  • To enhance oversight of Medicaid-related activities and the financial health of health care entities receiving public funds.
  • To empower the Executive Office of Health and Human Services (EOHHS) secretary with coordinated oversight, reporting, and corrective-action tools to ensure solvency, efficient operations, and alignment with state policy and budget priorities.

Key Provisions

Section 1: Amendments to Duties of the Secretary (RHODE ISLAND General Laws 42-7.2-5)

  • The Secretary of EOHHS will oversee and coordinate state-administered health and human services, including Medicaid section 1115 waiver activities, but without transferring legislative powers conferred on other departments.
  • The Secretary will:
    • Serve as governor’s chief advisor and liaison to federal policymakers on Medicaid reform.
    • Review Medicaid waiver requests, amendments, and related state plan changes to ensure legal/financial soundness and alignment with policy priorities; gather necessary information from department directors.
    • Direct development and implementation of Medicaid policies to support the integrated eligibility system and HealthSource RI (the state marketplace).
    • Conduct biennial comprehensive reviews of Medicaid eligibility criteria (starting from 2015 reference) to ensure consistency with laws, policy alignment, and opportunities for quality improvement and additional federal participation.
    • Prepare annual comprehensive overviews of Medicaid expenditures and utilization (beginning in 2020) for the governor, legislative committees, and caseload/cost analyses, including detailed breakdowns by population, service type, and agencies receiving federal funds; require cooperation from department directors, local governments, and school departments.
    • Resolve interdepartmental conflicts and oversee improvements in efficiency and accountability.
    • Lead organizational reforms to streamline human resources, pursue economies of scale, centralize fiscal functions, procurement, data management, and system integration.
    • Push for service delivery reforms to improve value, quality, and outcomes; support protective services for vulnerable populations; and centralize legal/administrative functions.
    • Prepare integrated budgets for health and human services for governor consideration.
    • Use objective data for policy evaluation, resource planning, and long-term forecasting.
    • Establish interdepartmental data management to support a consumer-centered integrated health and human services system.
    • Conduct independent program reviews at the Governor’s or General Assembly direction; report findings and recommendations.
    • Report regularly to the governor and suggest agenda items for health and human services.
    • Hire staff and contract as needed; ensure confidentiality/privacy compliance for data.
    • Hold department heads accountable for their agencies' actions.
    • Explore options for removing fixed eligibility thresholds by implementing sliding-scale benefits up to 450% of the federal poverty level (examples include medical assistance, childcare, and food assistance).
    • Prohibit insurers from requiring prior authorization for in-network primary care provider-ordered admissions/treatments, with exceptions for prescription drugs.
    • Convene an advisory working group to analyze potential federal Medicaid actions and develop compliance options; deliver a report by Oct. 31, 2025, ahead of the Governor’s 2026 budget submission.

Section 2: New Chapter 42-7.5 – Healthcare Entity Fiscal Integrity, Transparency, and Accountability

  • Establishes definitions related to fiscal integrity, reporting covered entities, and related concepts (e.g., assessment, audited financial statements, bad debt, financial risk, imminent financial jeopardy, etc.).
  • Defines “reporting covered entities” as:
    • Hospitals and parent organizations.
    • Nursing facilities and parent organizations.
    • Federally Qualified Health Centers (FQHCs).
    • Certified Community Behavioral Health Clinics (CCBHCs).
  • Quarterly Reporting Requirements (beginning Oct. 1, 2026):
    • Required quarterly financial reports including balance sheets, income statements, cash on hand, payables/receivables, revenues, operating costs, investments, non-patient services, assets/liabilities, net surplus/profit, uninsured and bad debt costs, and net charity care.
    • Format should consider ease of data collection and aim for electronic submission.
    • Reports due within 60 business days after each quarter’s end (Q1: Jan 1–Mar 31; Q2: Apr 1–Jun 30; Q3: Jul 1–Sept 30; Q4: Oct 1–Dec 31).
    • CFO or authorized signatory must attest to accuracy.
    • Secretary will review and use reports to assess financial status and risk; may determine financial risk or imminent financial jeopardy; provide findings 30 days before the next quarterly deadline when feasible.
    • May require corrective action plans for identified risks.

Section 3: Remedies and Compliance

  • Entities notified of report receipt, assessments, and findings; upon financial risk or imminent jeopardy, the Secretary will meet with the entity to document remediation strategies.
  • If risk or jeopardy is found:
    • Notify about possible corrective actions, cooperation obligations, required corrective-action plans and due dates, and consequences for noncompliance.
    • Entities must pay costs for independent analyses or forensic audits as part of corrective actions.
    • Secretary may require actions to mitigate risks to stabilize the health system.
    • If immediate government action is needed and no authority exists within agencies, recommendations can be escalated to the Governor.

Section 4: Disclosures and Federal Financing

  • Findings not protected by law or regulation may be disclosed.
  • Secretary may pursue federal Medicaid matching funds, grants, and foundation awards to stabilize entities in jeopardy and promote transparency.

Section 5: Rules and Regulations

  • Secretary authorized to promulgate rules to implement the chapter.

Effective Date

  • Takes effect upon passage.

Potential Impact

  • Increased oversight and centralized coordination of Medicaid and health/human services administration.
  • Greater transparency and regular financial scrutiny of major healthcare providers receiving public funds (hospitals, nursing facilities, FQHCs, CCBHCs).
  • Proactive risk identification and remediation to protect access to care and public health.
  • Possible financial stress for reporting entities required to produce quarterly detailed financial data and potentially implement corrective actions.
  • Enhanced ability for Rhode Island to align Medicaid policies with federal requirements and adapt to federal funding changes.

Who Would Be Affected

  • Secretary of EOHH S (EOHHS) and health and human services department directors.
  • Hospitals, nursing facilities, FQHCs, and CCBHCs and their parent organizations (as “reporting covered entities”).
  • Local governments and school departments, by obligation to cooperate with reporting and budgeting processes.
  • Health insurers may face regulatory constraints regarding prior authorizations for in-network primary care-admitted services.
  • State government, through increased reporting, budgeting, and potential use of federal funds to stabilize entities.

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

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