2024 -- S 2353 | |
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LC003993 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2024 | |
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A N A C T | |
RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE | |
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Introduced By: Senators LaMountain, Bissaillon, Burke, and Euer | |
Date Introduced: February 12, 2024 | |
Referred To: Senate Finance | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Section 40-8-2 of the General Laws in Chapter 40-8 entitled "Medical |
2 | Assistance" is hereby amended to read as follows: |
3 | 40-8-2. Definitions. |
4 | As used in this chapter, unless the context shall otherwise require: |
5 | (1) “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, |
6 | palliative treatment, and the refitting and relining of existing dentures and prosthesis. |
7 | (2) “Department” means the department of human services. |
8 | (3) “Director” means the director of human services. |
9 | (4) “Drug” means and includes only drugs and biologicals prescribed by a licensed dentist |
10 | or physician as are either included in the United States pharmacopoeia, national formulary, or are |
11 | new and nonofficial drugs and remedies. |
12 | (5) “Inpatient” means a person admitted to and under treatment or care of a physician or |
13 | surgeon in a hospital or nursing facility that meets standards of and complies with rules and |
14 | regulations promulgated by the director. |
15 | (6) “Inpatient hospital services” means the following items and services furnished to an |
16 | inpatient in a hospital other than a hospital, institution, or facility for tuberculosis or mental |
17 | diseases: |
18 | (i) Bed and board; |
19 | (ii) Nursing services and other related services as are customarily furnished by the hospital |
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1 | for the care and treatment of inpatients and drugs, biologicals, supplies, appliances, and equipment |
2 | for use in the hospital, as are customarily furnished by the hospital for the care and treatment of |
3 | patients; |
4 | (iii)(A) Other diagnostic or therapeutic items or services, including, but not limited to, |
5 | pathology, radiology, and anesthesiology furnished by the hospital or by others under arrangements |
6 | made by the hospital, as are customarily furnished to inpatients either by the hospital or by others |
7 | under such arrangements, and services as are customarily provided to inpatients in the hospital by |
8 | an intern or resident-in-training under a teaching program having the approval of the Council on |
9 | Medical Education and Hospitals of the American Medical Association or of any other recognized |
10 | medical society approved by the director. |
11 | (B) The term “inpatient hospital services” shall be taken to include medical and surgical |
12 | services provided by the inpatient’s physician, but shall not include the services of a private-duty |
13 | nurse or services in a hospital, institution, or facility maintained primarily for the treatment and |
14 | care of patients with tuberculosis or mental diseases. Provided, further, it shall be taken to include |
15 | only the following organ transplant operations: kidney, liver, cornea, pancreas, bone marrow, lung, |
16 | heart, and heart/lung, and other organ transplant operations as may be designated by the director |
17 | after consultation with medical advisory staff or medical consultants; and provided that any such |
18 | transplant operation is determined by the director or his or her designee to be medically necessary. |
19 | Prior written approval of the director, or his or her designee, shall be required for all covered organ |
20 | transplant operations. |
21 | (C) In determining medical necessity for organ transplant procedures, the state plan shall |
22 | adopt a case-by-case approach and shall focus on the medical indications and contra-indications in |
23 | each instance; the progressive nature of the disease; the existence of any alternative therapies; the |
24 | life-threatening nature of the disease; the general state of health of the patient apart from the |
25 | particular organ disease; and any other relevant facts and circumstances related to the applicant and |
26 | the particular transplant procedure. |
27 | (7) “Nursing services” means the following items and services furnished to an inpatient in |
28 | a nursing facility: |
29 | (i) Bed and board; |
30 | (ii) Nursing care and other related services as are customarily furnished to inpatients |
31 | admitted to the nursing facility, and drugs, biologicals, supplies, appliances, and equipment for use |
32 | in the facility, as are customarily furnished in the facility for the care and treatment of patients; |
33 | (iii) Other diagnostic or therapeutic items or services, legally furnished by the facility or |
34 | by others under arrangements made by the facility, as are customarily furnished to inpatients either |
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1 | by the facility or by others under such arrangement; |
2 | (iv) Medical services provided in the facility by the inpatient’s physician, or by an intern |
3 | or resident-in-training of a hospital with which the facility is affiliated or that is under the same |
4 | control, under a teaching program of the hospital approved as provided in subsection (6); and |
5 | (v) A personal-needs allowance of seventy-five dollars ($75.00) one hundred dollars |
6 | ($100) per month. |
7 | (8) “Relative with whom the dependent child is living” means and includes the father, |
8 | mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, |
9 | uncle, aunt, first cousin, nephew, or niece of any dependent child who maintains a home for the |
10 | dependent child. |
11 | (9) “Visiting nurse service” means part-time or intermittent nursing care provided by or |
12 | under the supervision of a registered professional nurse other than in a hospital or nursing home. |
13 | SECTION 2. This act shall take effect on July 1, 2024. |
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LC003993 | |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO HUMAN SERVICES -- MEDICAL ASSISTANCE | |
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1 | This act would increase the personal needs allowance of nursing facility residents from |
2 | seventy five dollars ($75.00) to one hundred dollars ($100) per month. |
3 | This act would take effect on July 1, 2024. |
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LC003993 | |
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