Chapter 04-611
2004 -- S 2882
AS AMENDED
Enacted 08/11/04
A N A C T
RELATING
TO INSURANCE -- ESTABLISHING A PILOT PRIMARY CARE PROGRAM FOR THE UNINSURED
Introduced
By: Senator Maryellen Goodwin
Date
Introduced: February 11, 2004
It
is enacted by the General Assembly as follows:
SECTION 1. Title
27 of the General Laws entitled "Insurance" is hereby amended by
adding
thereto the following chapter:
CHAPTER
68
PILOT
PRIMARY CARE PROGRAM FOR THE UNINSURED
27-68-1. Legislative
findings. – (a) The general assembly hereby finds and declares that:
(1)
Although Rhode Island has one of the highest rates of health insurance coverage
in
the
nation, gaps in coverage remain and the rate of coverage dropped significantly
during the past
year.
(2)
From 2001 to 2002, the state's uninsured rate for working age adults went from
eight
percent
(8%) to eleven percent (11%), one of eighteen (18) states in the country with a
significant
increase.
(3)
Significant health insurance premium rate increases over the past two (2) years
especially
for small businesses and the self-insured are contributing to an increase in
the rate of
the
uninsured.
(4)
The largest segment of uninsured Rhode Island residents are adults with low
incomes,
many
of whom are employed.
(5)
Individuals without health coverage often resort to expensive emergency room
care
that
ultimately drives up the overall cost of care for everyone and adds to the
state's
uncompensated
care burden.
(6)
Rhode Island residents use of emergency room services is greater than that of
the
nation.
(7)
The institute of medicine defines primary care as the provision of integrated,
accessible
health care services by clinicians who are accountable for addressing a large
majority
of
personal health care needs, developing a sustained partnership with patients,
and practicing in
the
context of family and community.
(8)
Access to primary health care should be available to every resident of the
state
regardless
of income and whether or not they have access to health insurance.
27-68-2. Pilot primary care
program established. – To increase access to primary care
for
those state residents who do not have access to health insurance coverage or
who are unable to
afford
health insurance coverage, the director of the state department of human
services in
collaboration
with the director of the department of health shall develop a plan for a pilot
primary
care
program for uninsured residents of the state. The pilot program may include
enrollee
premiums
and co-insurance payments that are income-based with premiums and/or
co-insurance
subsidized
by the state. The pilot program may also include catastrophic or reinsurance
coverage
provided
under the auspices of the state. In designing the pilot program, the director
may
consider
a variety of service delivery and financing models including capitation
payments to
private
physicians, a buy-in program under RIte Care and coverage arrangements
purchased from
qualified
community health centers. In developing the pilot program the director may seek
available
federal grant monies, including medicaid, and private foundation grants. The
director
shall
submit the plan for the pilot primary care program to the governor, the speaker
of the house,
the
president of the senate, the majority leaders of the house and senate and the
chairpersons of
the
house and senate finance committees by January 15, 2005. The plan shall include
eligibility
criteria
for participation in the pilot program, the scope of services to be offered,
the geographic
area
and population to be served, and cost estimates to implement the program.
SECTION
2. This act shall take effect upon passage.
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LC01927
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