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HR 8205

JOINT RESOLUTION TO AMEND THE MEDICAID SECTION 1115 DEMONSTRATION WAIVER REQUESTS AND RENEWALS

2026 Regular Session Introduced by Stephen Casey

authorize changes to Rhode Island's Medicaid 1115 waiver and state plan to add a behavioral health per-diem add-on and expand least-restrictive, specialized long-term care placemen

05/14/2026 Committee recommended measure be held for further study
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Bill Summary · HR 8205

Overview

  • Bill: HR 8205
  • Session: 2026
  • Jurisdiction: Rhode Island
  • Title: Joint Resolution to Amend the Medicaid Section 1115 Demonstration Waiver Requests and Renewals
  • Introduced by: Rep. Stephen M. Casey
  • Date Introduced: February 27, 2026
  • Referred to: House Finance
  • Status: Scheduled for hearing/consideration (May 14, 2026)

Purpose and Intent

  • The resolution seeks legislative authorization to pursue changes to Rhode Island’s Medicaid Section 1115 demonstration waiver and related state plan amendments.
  • The overarching goal is to create a more cost-effective, consumer-choice–oriented system of care that is fiscally sustainable and capable of reducing the number of days behaviorally complex patients spend in acute care facilities.

Key Provisions

  • Authorization for Waiver and Rule Changes:
    • The Secretary of the Executive Office of Health and Human Services (EOHHS) is authorized to pursue and implement waiver amendments, state plan amendments, and changes to department rules/regulations.
  • Behavioral Health Per-Diem Add-On Program:
    • The proposal focuses on updating the behavioral health per-diem add-on (BH P-D Add-On) for particularly complex patients. The intended beneficiaries are patients who:
    • Require nursing facility level of care and have complex needs that hinder placement in traditional nursing facilities.
    • Have a history of persistent, disruptive behaviors requiring moderate-to-frequent intervention.
    • Eligibility criteria appear to align with least restrictive setting principles (Olmstead v. L.C., 1999), supporting admission to a setting that is consistent with that requirement when appropriate.
    • Patients must meet nursing facility level of care criteria and have BHDDH (Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals) approval for specialized services through the BHDDH Level II PASRR (Preadmission Screening and Resident Review) determination process prior to nursing home admission.
    • The cấpability to provide specialized and individualized services to these complex patients is tied to Medicaid certification for the specific nursing facility services.
  • Demonstration Waiver Context:
    • The changes target the Medicaid Section 1115 demonstration waiver and any related category II or III changes that could affect the scope, amount, duration, or access to publicly funded health care services and provider payments.
    • The intent is to implement these changes through waiver amendments or state plan amendments consistent with federal waivers’ oversight.

Affected Entities and Individuals

  • Rhode Island residents who require long-term care and have complex behavioral health needs.
  • Nursing facilities, particularly those serving residents with behavioral health needs and those approved for Level II PASRR–related specialized services.
  • BHDDH (Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals) for eligibility determinations and approval for specialized services.
  • The Rhode Island Department of Health and EOHH (Executive Office of Health and Human Services) in implementing waiver amendments and related regulatory changes.
  • The Secretary of the EOHHS, who would oversee pursuing and implementing these changes.

Procedural and Timeline Aspects

  • Legislative Path:
    • The resolution follows the standard process for legislative action to amend Medicaid waiver requests and renewals, invoking statutory oversight requirements under Rhode Island law (G.L. § 42-12.4-3 and § 42-7.2-5(3)(i)).
    • It directs the Secretary to coordinate waivers, state plan amendments, and rule changes through the appropriate agencies.
  • Effective Timing:
    • The resolution does not set a specific effective date for the changes; rather, it authorizes the relevant state agencies to pursue and implement amendments as part of the waiver request/renewal process.
  • Communications:
    • The Secretary of State is authorized to transmit certified copies of the resolution to the Governor, the Rhode Island Department of Health, and the EOHHS.

Potential Impacts

  • Economic: Aims to create a more cost-effective approach to caring for behaviorally complex patients, potentially reducing costly stays in acute care facilities by enabling appropriate, specialized long-term care placements.
  • Access and Quality: Seeks to expand access to suitable, least-restrictive settings for eligible individuals and align care with Olmstead principles.
  • Policy Alignment: Aligns Rhode Island’s Medicaid demonstration activities with demonstrable improvements in care coordination, specialized services, and the use of the BH per-diem add-on to support complex needs.

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

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