Medicaid/CHIP Data Requirements

Rhode Island passed a Medicaid reform bill in 2008 that requires the executive office of health and human services to reform the Medicaid system “so that it is a person-centered, financially sustainable, cost-effective, and opportunity driven program…”1

Rhode Island provides Medicaid services for families through a managed care system that utilizes the medical home model and emphasizes both preventive and primary care.2 The department of human services may provide a Medicaid buy-in program to persons with disabilities3 and elect to establish a program for all-inclusive care (PACE) for elderly persons.4 The department should, when appropriate, provide “enhanced services” (e.g. care coordination, home visitation) to pregnant women eligible for Medicaid.5 The department must implement the “RIte Track Program” to act as the payor of last resort for children under the age of 19 who lack health insurance but have a family income above the 250% threshold.6 RIte Track services will be provided through a managed care system. Person’s that apply for Medicaid funded long-term care services must receive long-term care counseling.7