H 7010Medical Services

Human Services - Medical Assistance

This bill allows licensed independent clinical social workers to bill Medicaid directly for services provided to adults.

Held for study

Population
Affected

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Introduced Jan 7, 2026Committee House Finance

Plain-English Summary

This bill mandates that the state Medicaid program must pay for services provided by licensed independent clinical social workers (LICSWs). Specifically, it allows these social workers to enroll directly with Medicaid and bill the state for authorized mental health services provided to adults who have Medicaid fee-for-service coverage. The bill directs state officials to create a specific fee schedule and the necessary rules to manage these payments, ensuring these professionals can be reimbursed directly for their work rather than needing to bill through other agencies or organizations.

For younger readers

This new rule helps adults get help for their mental health. There are special helpers called clinical social workers who talk to people when they are sad, worried, or having a hard time. Before this law, it was sometimes difficult for these workers to get paid by the government health insurance called Medicaid. Now, the government must pay these social workers directly when they help adults. This makes it easier for the social workers to do their jobs and for people to find someone to talk to when they need help.

Who & Where It Applies

Impacted groups

Licensed Independent Clinical Social Workers (LICSWs)Adult Medicaid recipientsMedicaid administratorsMental health patientsTaxpayers

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

Amount unknown

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Expands access to mental health services for low-income populations by increasing the network of available providers who can bill Medicaid directly.
Strengthens the social safety net by removing administrative barriers that previously prevented some qualified social workers from treating Medicaid recipients.
Empowers labor and healthcare workers by allowing independent social workers to sustain their practice through direct reimbursement, rather than relying on larger corporate agencies.
Relies on a fee-for-service model, which some progressives argue prioritizes the quantity of visits over the quality and holistic value of patient care.
Does not explicitly address reimbursement rates, which, if set too low by the director, may result in a system where providers still refuse to accept Medicaid patients.
Specifically limits the mandate to services provided to "adults," potentially leaving gaps in coverage availability for children and adolescents in need of similar direct-access care.

For Conservatives

Reduces bureaucratic red tape by allowing private practitioners to bill directly, rather than forcing them to work through larger, potentially inefficient intermediary agencies.
Supports small business owners (independent clinical social workers) by enabling them to operate their private practices more autonomously and financially sustainably.
Promotes market competition in the healthcare sector by expanding the pool of eligible providers, potentially offering patients more choice in their care.
Expands government spending by mandating new avenues for Medicaid payouts, which will likely increase the burden on taxpayers.
Increases the size and scope of the state's welfare apparatus, entrenching government involvement in the healthcare marketplace.
Delegates authority to unelected bureaucrats to promulgate new rules and fee schedules, expanding the administrative state.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 7 additions

SECTION 1. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby amended by adding thereto the following section: 40-8-33. Licensed independent clinical social workers - Services covered. Notwithstanding any general law, public law, special law, rule or regulation to the contrary, Medicaid reimbursement shall be provided under this chapter for services by licensed independent clinical social workers and those workers shall be entitled to enroll and bill Medicaid fee-for- service directly for authorized and/or covered services provided to adults with Medicaid fee-for- service coverage. The director is hereby directed to develop and promulgate a fee schedule and any necessary rules or regulations required to implement the provisions of this section.

SECTION 2. This act shall take effect upon passage.