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SB 3253

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

2026 Regular Session Introduced by Bob Britto and 4 co-sponsors

Centralizes oversight under EOHHS, expanding Medicaid governance and creating a quarterly financial reporting regime to detect and address at-risk health entities.

05/05/2026 Introduced, referred to Senate Finance
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Bill Summary · SB 3253

Summary of Bill SB 3253 (Rhode Island, 2026)

Purpose and Intent

SB 3253 would reorganize oversight of health and human services in Rhode Island by enhancing the powers and duties of the Secretary of the Executive Office of Health and Human Services (EOHHS). The act aims to promote fiscal integrity, transparency, and accountability across state-administered healthcare and human services programs, improve efficiency and coordination, and provide mechanisms to address financial risk and jeopardy among reporting healthcare entities.

Key Provisions and Changes

  • Expanded Secretary Powers and Responsibilities (Section 42-7.2-5)

    • The secretary would coordinate, oversee, and financially direct state health and human services, including Medicaid 1115 waiver activities and, where applicable, the state plan under Title XIX.
    • Serve as the governor’s chief advisor on Medicaid reform and as the primary state contact with federal policymakers.
    • Review, coordinate, and assess any Medicaid waiver requests and state plan amendments that could affect eligibility, benefits, provider payments, or access.
    • Develop and implement Medicaid policies to support the state’s integrated eligibility system and HealthSource RI.
    • Conduct biennial reviews (beginning 2015 as stated) of Medicaid eligibility criteria to improve consistency, quality, access, and potential cost-sharing or participation changes.
    • Prepare annual comprehensive Medicaid expenditure overviews starting in 2020, detailing spending by titles XIX/XXI, populations served, providers, service types, and Core Set reporting to ensure compliance with federal measures.
    • Lead system-wide reforms to integrate service delivery, maximize resources, centralize administrative functions, and coordinate legal/claims functions.
    • Create an assessment and coordination unit to rebalance long-term services to ensure appropriate, least-restrictive settings.
    • Improve program integrity, cost recovery, and protection for vulnerable populations.
    • Prepare comprehensive budgets for health and human services and submit to the state budget office.

  • Advisory Group on Federal Medicaid Actions (Section 42-7.2-5(17))

    • Establish an advisory working group to analyze potential impacts of federal actions on Medicaid and propose administrative or legislative options.
    • Deliver a report by October 31, 2025, after the 2026 federal budget is known.

  • New Chapter: Healthcare Entity Fiscal Integrity, Transparency, and Accountability (Chapter 42-7.5)

    • Introduces definitions and a framework for assessing the financial health of reporting covered entities (e.g., hospitals, nursing facilities, FQHCs, CCBHCs) and their parent organizations.
    • Quarterly Reporting Requirement (Beginning Oct 1, 2026):
    • Reporting covered entities must submit quarterly financial reports to the secretary, including cash on hand, payables/receivables, revenues, costs, investments, bad debt, charity care, and other data.
    • Reports must be submitted within 60 business days after each quarter and signed by the entity’s CFO.
    • The secretary will review reports to assess financial status and identify risks of financial risk or imminent financial jeopardy.
    • The secretary may require corrective action plans and may impose remedies to stabilize the health system.
    • Remedies and Notifications:
    • Entities will be notified of findings and required to cooperate; corrective actions and timelines will be specified.
    • Costs for independent analyses (e.g., forensic audits) may be borne by the reporting entity.
    • If necessary, recommendations can be escalated to the Governor for resolution.
    • Limitations:
    • The act does not obligate continued financial aid to entities found at risk.
    • Transparency and Federal Funding:
    • Findings may be disclosed where permitted by law.
    • The secretary may pursue federal funding or grants to stabilize at-risk entities.

  • Regulatory Authority (Section 42-7.5-7)

    • The secretary would have rulemaking authority to implement these provisions.

Who and What Is Affected

  • State Agencies and Health and Human Services Departments: Direct oversight, budgeting, policy development, and integration efforts will be centralized under EOHHS.
  • Reporting Covered Entities: Hospitals, nursing facilities, federally qualified health centers (FQHCs), and certified community behavioral health clinics (CCBHCs) and their parent organizations will be subject to quarterly financial reporting and potential corrective actions.
  • Governors and Legislature: Enhanced reporting to inform budget decisions and potential federal compliance actions.
  • Public: Increased transparency of financial health within major healthcare entities and potential impacts on service access if remediation actions are needed.

Timelines and Procedures

  • Effective date: Upon passage.
  • Quarterly reporting begins: October 1, 2026.
  • Quarterly reports due: Within 60 business days after each quarter’s end (quarters aligned with calendar year).
  • Advisory group report on federal Medicaid actions: Due no later than October 31, 2025.
  • The act authorizes rulemaking to implement specifics.

Summary

SB 3253 centralizes health and human services leadership under EOHHS, enhances Medicaid governance and financial oversight, and introduces a new fiscal integrity regime for major healthcare entities. The bill seeks to improve fiscal transparency, identify and address financial risks, and ensure stability and accountability across Rhode Island’s health system while maintaining legislative and gubernatorial oversight.

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

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