TITLE 42
State Affairs and Government
CHAPTER 42-7.2
Office of Health and Human Services
SECTION 42-7.2-16
§ 42-7.2-16 Medicaid System Reform 2008.
(a) The executive office of health and human services, in conjunction with the
department of human services, the department of children, youth and families,
the department of health and the department of behavioral healthcare,
developmental disabilities, and hospitals, is authorized to design options that
further the reforms in Medicaid initiated in 2008 to ensure that the program:
utilizes competitive and value based purchasing to maximize the available
service options, promotes accountability and transparency, and encourages and
rewards healthy outcomes, independence, and responsible choices; promotes
efficiencies and the coordination of services across all health and human
services agencies; and ensures the state will have a fiscally sound source of
publicly-financed health care for Rhode Islanders in need.
(b) Principles and Goals. In developing and
implementing this system of reform, the executive office of health and human
services and the four (4) health and human services departments shall pursue
the following principles and goals:
(1) Empower consumers to make reasoned and cost-effective
choices about their health by providing them with the information and array of
service options they need and offering rewards for healthy decisions;
(2) Encourage personal responsibility by assuring the
information available to beneficiaries is easy to understand and accurate,
provide that a fiscal intermediary is provided when necessary, and adequate
access to needed services;
(3) When appropriate, promote community-based care solutions
by transitioning beneficiaries from institutional settings back into the
community and by providing the needed assistance and supports to beneficiaries
requiring long-term care or residential services who wish to remain, or are
better served in the community;
(4) Enable consumers to receive individualized health care
that is outcome-oriented, focused on prevention, disease management, recovery
and maintaining independence;
(5) Promote competition between health care providers to
ensure best value purchasing, to leverage resources and to create opportunities
for improving service quality and performance;
(6) Redesign purchasing and payment methods to assure fiscal
accountability and encourage and to reward service quality and
cost-effectiveness by tying reimbursements to evidence-based performance
measures and standards, including those related to patient satisfaction; and
(7) Continually improve technology to take advantage of
recent innovations and advances that help decision makers, consumers and
providers to make informed and cost-effective decisions regarding health care.
(c) The executive office of health and human services shall
annually submit a report to the governor and the general assembly describing
the status of the administration and implementation of the Medicaid Section
1115 demonstration waiver.
History of Section.
(P.L. 2008, ch. 100, art. 17, § 2; P.L. 2012, ch. 241, art. 18, § 1;
P.L. 2015, ch. 141, art. 5, § 20.)