Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
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Rhode Island Current

9 stories

Industry·RI·1d ago

Brown University Health Cuts Jobs Citing Medicaid-Driven Cost Pressures

Brown University Health, Rhode Island's largest hospital system, announced buyouts for up to 200 non-clinical supervisors and layoffs of an unspecified number of executives, effective the start of its new fiscal year. CEO John Fernandez cited rising pharmaceutical, labor and supply costs alongside growing uncompensated care, insurer denials and bad debt. The system attributes much of the pressure to federal policy changes restricting Medicaid eligibility and ending exchange subsidies, projecting $346 million in charity care, denials and debt costs for fiscal 2027, $71 million more than the prior year, and a $64 million deficit. Despite the cuts, the system plans $210 million in capital facility upgrades and a January merit increase, and will end employee health plan coverage of GLP-1 drugs for weight loss starting Jan. 1.

State Policy·RI·3d ago

Rhode Island Ends Medicaid GLP-1 Weight-Loss Coverage, Cuts Noncitizen Eligibility

Rhode Island Medicaid implemented five changes effective Oct. 1, the start of the federal fiscal year. Under the federal H.R. 1 law, asylees, refugees, parolees, and trafficking victims lose Medicaid eligibility unless they qualify through another status; the state estimates fewer than 3,500 noncitizens will be affected, though green card holders, Compact of Free Association migrants, and lawfully residing children and pregnant/postpartum women retain coverage. Separately, driven by the state budget rather than federal law, Rhode Island Medicaid will stop covering GLP-1 drugs like Wegovy and Zepbound when prescribed for weight loss, while continuing coverage for diabetes indications. The state projects the GLP-1 cut will save $6.3 million in general revenue and $20.3 million in combined state-federal funding; managed care plans were directed to review affected patients' treatment plans before the cutoff. Rhode Island is at least the seventh state in 2026 to drop GLP-1 obesity coverage.

State Policy·RI·5d ago

Rhode Island AG Rejects Turnaround Plan for Safety-Net Hospitals

Rhode Island Attorney General Peter Neronha's office rejected a financial turnaround plan submitted by CharterCARE Health of Rhode Island, the new owner of Roger Williams Medical Center and Our Lady of Fatima Hospital, saying it relied on unrealistic assumptions. The plan was required under conditions imposed when the hospitals' sale to nonprofit owner The Centurion Foundation closed in March. Neronha gave the owners until October 2 to submit a revised plan, warning the hospitals could be at risk of closing by year's end despite an $85 million cash infusion required at sale closing. Both hospitals serve large shares of Medicaid and Medicare patients and face pressure from new federal Medicaid eligibility requirements and funding cuts expected to increase uncompensated care.

State Policy·RI·10d ago

Rhode Island Outlines Rural Health Projects Under $156M Federal Award

Rhode Island is developing plans for its $156.17 million allocation from a nationwide rural healthcare funding program enacted in July 2026. The state is working to finalize project details ahead of an October federal deadline. The funding is part of a $50 billion national initiative targeting rural health infrastructure and services. Rhode Island Medicaid agencies and providers serving rural populations should monitor how these dollars will be deployed and whether Medicaid-funded services or facilities are included in the state's implementation plan.

State Policy·RI·12d ago

Rhode Island Redesigns Medicaid and Public Benefits Decision Notices for Clarity

Rhode Island has redesigned the decision notices sent to approximately 60,000 residents monthly regarding Medicaid coverage and other public benefits. The redesigned notices aim to make approval, denial, and change decisions easier to understand for beneficiaries. The changes took effect this month. The redesign matters for state agencies and health plans because clearer notices can reduce appeals, call center volume, and coverage gaps caused by beneficiary confusion about eligibility decisions.

State Policy·RI·31d ago

Rhode Island Governor Pledges $16M Medicaid Primary Care Rate Increase in 2027 Budget

Rhode Island Governor Dan McKee announced plans to include $16 million in his next budget to increase Medicaid reimbursement rates for primary care providers. The commitment follows a yearlong review by the state's Office of the Health Insurance Commissioner examining primary care payment rates. The proposal would take effect with the fiscal year 2027 state budget if McKee is reelected. The rate increase responds to chronic concerns about Medicaid primary care access and provider participation driven by below-market fee schedules.

Managed Care·RI·34d ago

Rhode Island Launches Phone Consultation Program Connecting Primary Care to Behavioral Health

Rhode Island has implemented a phone-based consultation program that allows primary care physicians to connect directly with behavioral health specialists to support patient care. The program addresses the challenge of integrating behavioral health services into primary care settings, where physician shortages mean every visit carries increased clinical weight. The initiative aims to improve access to behavioral health treatment by enabling real-time specialist consultation without requiring separate referrals or appointments. For Medicaid providers and managed care organizations, this represents a care coordination model that can reduce emergency department utilization and improve outcomes for members with co-occurring physical and behavioral health needs.

Industry·RI·43d ago

Brown University Health Reports Break-Even as Uncompensated Care and Medicaid Pressures Mount

Brown University Health reported returning to break-even financial performance but warned of continued strain from uncompensated care costs, insurance denials, and federal Medicaid restrictions. CFO Peter Markell stated that break-even is insufficient for long-term sustainability. The system faces ongoing financial pressure from Medicaid reimbursement constraints and rising uncompensated care burdens. The announcement comes amid uncertainty about services at Newport Hospital's birthing center, though the health system declined to provide details.

State Policy·RI·115d ago

Rhode Island Faces Decision on Medicaid Coverage for GLP-1 Weight Loss Drugs

Rhode Island is considering whether to maintain Medicaid coverage for GLP-1 medications used to treat obesity, amid national debate over cost and access. The state has historically prioritized public health initiatives addressing health disparities and nutrition. The decision affects coverage policy for medications like Wegovy and Zepbound for Medicaid beneficiaries with obesity. Rhode Island's choice will impact managed care organizations' pharmacy benefits and utilization management protocols for this high-cost drug class.

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