Good News from PCMH-Kids!

  • 15 Aug 2022

This year’s legislative session ended in late June and finalized the RI State budget for FY23 (July 2022-June 2023). Both the legislative package and the budget included increased state support for child and family health. Among the measures passed, we’d like to highlight the following four which have the potential to impact access and quality, improving child health in RI.

Expansion of Postpartum Coverage for Birth-Persons on RIte Care: The FY23 budget allows women who give birth while enrolled in RIte Care to stay continuously enrolled for 12 months after giving birth, instead of the current 60 days, and provides state funds to allow coverage regardless of immigration status.

Eligibility for Medicaid for all low-income children, regardless of immigration status: This provision uses state-only funds to enroll income-eligible children up to age 19 in Medicaid’s RIte Care program, regardless of immigration status. It allows access to medical care, medications and immunizations for income-eligible children regardless of immigration status.

Pediatric Medicaid Relief: The state budget includes funding for a 3rd round of Pediatric Medicaid Relief. This quality improvement initiative will focus on improving childhood and adolescent immunization rates and screening toddlers for lead poisoning. It will also include supporting practices in children’s behavior health.

Medicare parity for Medicaid rates for Pediatric Primary Care codes: RI has had among the lowest Medicaid rates for pediatric care in the nation. This exciting rate increase is an important step toward addressing the payment gaps that have led to chronically underfunded child health infrastructure in RI. While RI EOHHS is currently working on contract amendments with MCO’s, these rates will be retroactive to July 1, 2022.

The plan is to apply the increase to the following Evaluation and Management codes:

New patient:  99201 - 99205; 99381 – 99387

Established patient: 99211 - 99215; 99391 – 99396

We want to express our deep gratitude to the RI State legislature and to our partners at EOHHS for this support.