On Behalf of EOHHS,
Hello,
The Secretary of the Rhode Island Executive Office of Health and Human Services (EOHHS) has under consideration one (1) amendment to Medicaid regulation. The regulation with proposed amendments and the reason for the amendments are summarized below.
Medicaid Payments and Providers, 210-RICR-20-00-1
In response to emerging concerns related to potential fraud, waste, and abuse (FWA) and the health and safety of Medicaid beneficiaries, the Rhode Island Executive Office of Health and Human Services (EOHHS) is proposing updates to the Community Health Worker (CHW) program to strengthen oversight, safeguard beneficiary health and safety and Medicaid funds, and ensure the continued integrity of the program.
EOHHS has identified a need to enhance provider screening and improve documentation and billing standards to better align with federal and state program integrity requirements . As part of this effort, CHW providers will be designated as high-risk provider for the purposes of enrollment, which will include additional screening measures to protect the health and safety of Medicaid members and promote the appropriate use of Medicaid resources.
These updates are necessary to maintain compliance with federal Medicaid standards and to preserve continued access to federal funding.
*Note: An emergency promulgation with the proposed changes is currently in effect and this promulgation is intended to supersede the emergency version when complete.
The proposed rule is accessible on the R.I. Secretary of State’s website: Welcome to the Rhode Island Code of Regulations – Rhode Island Department of State (ri.gov), the EOHHS website: www.eohhs.ri.gov, or available in hard copy upon request (401 462-2598 or RI Relay, dial 711). Interested persons should submit data, views, or written comments by July 25, 2025 to Katy Thomas, RI Executive Office of Health & Human Services, Virks Building, 3 West Rd, Cranston, RI 02920 or Kathryn.thomas@ohhs.ri.gov.
In accordance with R.I. Gen. Laws 42-35-2.8, an oral hearing will be granted if requested by twenty-five (25) persons, by a governmental agency or by an association having at least twenty-five (25) members. A request for an oral hearing must be made within ten (10) days of the publication of this notice.