2026 -- H 7400

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LC004466

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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J O I N T   R E S O L U T I O N

MAKING AN APPROPRIATION OF THE SUM OF $118,422 TO THE RHODE ISLAND

PARENT INFORMATION NETWORK TO CONTINUE THE OPERATION OF THE RIPIN

DUAL OBUDSMAN PROGRAM

     Introduced By: Representatives Spears, Carson, Messier, Speakman, Shanley, McEntee,
Baginski, Kazarian, Cotter, and Donovan

     Date Introduced: January 28, 2026

     Referred To: House Finance

     WHEREAS, The approximately 40,000 Rhode Islanders with coverage through both

Medicare and Medicaid, known as “dual-eligible enrollees” or “duals” are some of the most

medically fragile Rhode Islanders; and

     WHEREAS, Medicare and Medicaid are poorly coordinated programs, coverage options

for duals are complex, and transitions in forms of coverage can have serious adverse impacts on

duals if significant outside assistance is not available to ensure needed medical services continue;

and

     WHEREAS, The Executive Office of Health and Human Services (“EOHHS”) had

established, in conjunction with the Centers for Medicare and Medicaid Services (“CMS”), a

dual-specific Medicare-Medicaid Plan (“MMP”) which integrated Medicare and Medicaid

benefits within a single plan, operated by Neighborhood Health Plan of Rhode Island (“NHPRI”)

as Neighborhood Integrity, since July 1, 2016; and

     WHEREAS, CMS withdrew support for the MMP effective December 31, 2025,

requiring EOHHS and NHPRI to end the Neighborhood Integrity plan and transition its enrollees

into a new form of coverage known as a “Fully-Integrated Duel Eligible Special Needs Plan” or

“FIDE-SNP”; and

     WHEREAS, In late 2023, EOHHS issued a procurement for Medicaid Managed Care

services whereby awarded vendors would operate plans for duals that integrated Medicare and

Medicaid benefits within a single plan, but EOHHS subsequently canceled that procurement,

leaving the future of the managed care delivery system for duals in Rhode Island in a state of

confusion and flux; and

     WHEREAS, CMS has recently promulgated proposed rules which allow for more

aggressive advertising of Medicare plans to enrollees including duals, while reducing

enforcement of fraudulent or misleading behavior by Medicare plan brokers, and reducing the

availability of trusted resources such as the Senior Health Insurance Assistance Programs

(“SHIPs”), which are expected to lead to significant confusion for duals navigating an evolving

and complicated menu of plans with fewer trusted resources to turn to when issues arise; and

     WHEREAS, Approximately 11,300 duals are currently enrolled in the NHPRI FIDE-

SNP, and a further approximately 13,000 duals are enrolled in other dual-specific Medicare plans

(called “dual special needs plans” or “D-SNPs”); and

     WHEREAS, The Rhode Island parent Information Network (RIPIN) has operated, since

2016, Rhode Island’s Medicare-Medicaid Dual Ombudsman Program (the “RIPIN Dual

Ombudsman”), which helps duals navigate complicated Medicare and Medicaid enrollment rules,

Medicaid redeterminations, obstacles to health plan enrollment, claim and prior authorization

denials, access to care challenges, provider disputes, and applications for other federally-funded

benefit programs; and

     WHEREAS, The RIPIN Dual Ombudsman is funded through Medicaid administrative

matching with half federal Medicaid funding and half state funding, in the amount of $236,844

all-funds ($118,422 general revenue) per year, serving 467 clients in 2025, with 4,705 individual

client interactions, and with a 90% client satisfaction rate; and

     WHEREAS, The RIPIN Dual Ombudsman has helped its clients save more than $2.1

million in health care costs since January 1, 2018; and

     WHEREAS, The Governor’s proposed fiscal year 2027 budget proposes to terminate

funding for the RIPIN Dual Ombudsman; and

     WHEREAS, One hundred eighteen thousand four hundred twenty-two dollars ($118,422)

in general revenue would leverage an additional $118,422 in federal revenue and would allow the

RIPIN Dual Ombudsman program to operate at current capacity for the 2027 fiscal year; and

     WHEREAS, Without the RIPIN Dual Ombudsman, there will be no dedicated resource to

assist duals, and the sunset of that program would coincide with the largest system transition in

the history of Rhode Island’s managed care duals delivery system; and

     WHEREAS, Continued funding for the RIPIN Dual Ombudsman is in keeping with the

EOHHS's Mission Statement “to foster and strengthen a community-driven, equitable,

comprehensive, responsive, and high-quality health and human services system in Rhode Island”;

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now, therefore be it

     RESOLVED, That there is hereby appropriated, out of any money in the treasury not

otherwise appropriated for the fiscal year 2027, the total sum of one hundred eighteen thousand

four hundred twenty-two dollars ($118,422) in general revenue to RIPIN to continue the

operation of the RIPIN Dual Ombudsman, with the expectation that such funds will be matched

by federal Medicaid funds; [with such funds to be administered by the office of the health

insurance commissioner;] and the state controller is hereby authorized and directed to draw their

orders upon the general treasurer for the payment of said sum, upon receipt of properly

authenticated vouchers.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

J O I N T   R E S O L U T I O N

MAKING AN APPROPRIATION OF THE SUM OF $118,422 TO THE RHODE ISLAND

PARENT INFORMATION NETWORK TO CONTINUE THE OPERATION OF THE RIPIN

DUAL OBUDSMAN PROGRAM

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     This joint resolution would authorize the appropriation of the sum of one hundred

eighteen thousand four hundred twenty-two dollars ($118,422) to the Rhode Island Parent

Information Network (“RIPIN”) to support RIPIN’S continued operation of Rhode Island’s

Medicare-Medicaid Dual Ombudsman Program.

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