A sweeping legislative package designed to improve healthcare access and affordability in Rhode Island, known as the Rhode Island HEALTH Initiative (Holistic Enhancement and Access Legislation for Total Health), has been approved by the General Assembly and is now awaiting the Governor’s signature.

Announced in March by Senate President Dominick J. Ruggerio, Senate Majority Leader Ryan W. Pearson, Senate Health & Human Services Committee Chairman Joshua Miller, Senate Environment & Agriculture Committee Chairwoman Alana M. DiMario, and Senate Health & Human Services Committee Secretary Pamela J. Lauria, the initiative seeks to address the critical challenges facing the state’s healthcare system.

“Few issues are as important as healthcare, and right now, our healthcare system is in critical condition. Healthcare must be accessible and affordable for all Rhode Islanders. But for too many people in our state, care is too expensive or too difficult to get. And we know that many healthcare providers are feeling enormous strain due to many factors. Like providers and consumers, our community hospitals, including Fatima in my district, are facing difficult circumstances,” said President Ruggerio (D-Dist. 4, North Providence, Providence). “I want to recognize the outstanding work of my colleagues in the Senate in the development of this package of bills and thank our many partners, including vital stakeholders, for working collaboratively with us on these issues. As we celebrate our victories in the 2024 session, we remain committed to continuing our work on this issue and accomplishing all the objectives of the HEALTH Initiative.”

“We are very fortunate in the Senate to have such a knowledgeable and dedicated membership committed to addressing the challenges facing our state. When we approached the development of this package of bills, we wanted to take a holistic approach to addressing the many intertwined factors that impact the healthcare system. These bills – the Rhode Island HEALTH Initiative – are taking important steps that, taken together, will have a real impact on improving the health of our healthcare system, containing costs for providers and consumers, and improving access to care,” said Leader Pearson (D-Dist. 19, Cumberland, Lincoln).

Consumer Protection

“As a licensed mental health counselor, I am closely connected to the struggles of patients as they navigate so many facets of their lives. But for too many, simply trying to navigate our healthcare system only adds to their struggle. It’s more than just the cost – it’s the obstacles they too often face in terms of transparency and predictability. That’s why we focused on consumer protections as a pillar of this initiative,” said Chairwoman DiMario (D-Dist. 36, North Kingstown, Narragansett, New Shoreham).

Key legislation under this pillar includes:

• Hospital determination of Medicare & Medicaid eligibility for uninsured patients (Sponsored by Sen. Lauria, 2024-S 2714Aaa): Requires hospitals to screen uninsured patients for Medicaid, Medicare, and other financial assistance programs, and hold invoices until 30 days after discharge for application review. This legislation has passed the General Assembly and will be sent to the Governor.
• State purchase of medical debt through ARPA funding (Sponsored by Sen. Mark McKenney, 2024-S 2712Aaa): Utilizes federal funds to buy and eliminate medical debt for eligible Rhode Islanders. This measure was incorporated into the FY25 state budget, now signed into law.
• Prohibition on medical debt reporting to credit bureaus (Sponsored by Sen. Melissa Murray, 2024-S 2709A): Prohibits debt collectors from reporting medical debt to credit bureaus and sets rules for communication and false representation. This legislation has passed the General Assembly and will be sent to the Governor.

Provider Availability & Care Quality

“Over the years in my work as a primary care nurse practitioner, it has become increasingly clear the many ways in which our healthcare system is struggling. A shortage of providers across all facets of the health system is an especially urgent concern, and while that starts with primary care, it extends to nurses, specialists, counselors, and beyond. One of the pillars of the Rhode Island HEALTH initiative seeks to address the issue of provider availability, because to truly ensure everyone has access to quality care, we must have enough providers to meet our needs,” said Senator Lauria (D-Dist. 32, Barrington, Bristol, East Providence).

Legislation under this focus includes:

• Enhanced Curriculum & Clinical Training (Sponsored by Sen. Lauria, 2024-S 2716A): Allocates $2.7 million to primary care practices for training future healthcare providers. This measure was incorporated into the FY25 state budget, now law.
• Primary Care Scholarship Program (Sponsored by Sen. Lauria, 2024-S 2717A): Part of the Wavemaker Scholarship Program, it funds scholarships for primary care physicians, nurse practitioners, and physician’s assistants who commit to practicing in Rhode Island. This program was also incorporated into the FY25 state budget.
• Social Work Interstate Licensure Compact (Sponsored by Sen. DiMario, 2024-S 2184A): Establishes an interstate licensure credential for social workers, increasing access to mental health support. Passed by the General Assembly and sent to the Governor.
• Counseling Compact (Sponsored by Sen. Matthew LaMountain, 2024-S 2183): Adopts an existing compact to increase mental health support access. Passed by the General Assembly and sent to the Governor.
• Audiology Compact (Sponsored by Senate President Pro Tempore Hanna Gallo, 2024-S 2173): Establishes a compact for audiology and speech-language pathology. Passed by the General Assembly and sent to the Governor.
• Occupational Therapy Compact (Sponsored by Sen. Miller, 2024-S 2623A): Adopts the Occupational Therapy Licensure Compact. Passed by the General Assembly and sent to the Governor.
• NCLEX Pending Exemption (Sponsored by Senate Majority Whip Valarie Lawson, 2024-S 2083): Allows nurses to practice before taking the NCLEX exam. Passed by the General Assembly and sent to the Governor.

Cost Containment

“Healthcare is an extremely complex policy area. The details can be daunting, and consensus can be difficult to reach. I am grateful to Senate leadership, the members of the Health & Human Services Committee, the staff members and stakeholders who support and inform our work, and my colleagues for their efforts to advance this initiative. We have made cost containment a priority because it’s no secret that inflation has placed financial strain on Rhode Islanders, and increasing medical costs are not sustainable for our state’s working families,” said Chairman Miller (D-Dist. 28, Cranston, Providence).

The primary cost containment measure:

• Price Transparency (Sponsored by Senate Minority Leader Jessica de la Cruz, 2024-S 2078): Requires hospitals to publish pricing information for 300 “shoppable services” and a comprehensive file for all items and services. Passed by the General Assembly and sent to the Governor.

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