Rhode Island Unveils Comprehensive Strategy to Combat Healthcare Crisis

News Summary

Attorney General Peter Neronha has announced a multipronged strategy to address Rhode Island’s healthcare crisis, which he describes as a critical failure. The plan includes legislation to raise Medicaid payments, legal actions against Pharmacy Benefit Managers, and initiatives to enhance primary care services. With rising concerns about low reimbursement rates and hospital closures, Neronha aims to restructure the healthcare system and improve both revenue streams and operational efficiency. This comprehensive approach is expected to be rolled out ahead of the 2026 legislative session.

Rhode Island Addresses Healthcare Crisis with New Proposals

Rhode Island’s healthcare system is facing a critical juncture, with Attorney General Peter Neronha calling for immediate and comprehensive changes to avert what he describes as a looming collapse. In a recent announcement, Neronha presented a multipronged strategy that includes proposed legislation, litigation, research initiatives, and strategic partnerships aimed at addressing this escalating healthcare crisis.

Neronha characterized the current state of healthcare in Rhode Island as a “spectacular failure”, highlighting the urgent need for reforms. He emphasized that one of the primary issues plaguing the system is persistently low reimbursement rates from Medicare, Medicaid, and commercial payers, creating significant financial strain on healthcare providers.

The attorney general’s concerns were further supported by ongoing merger reviews, including the deal between Care New England and Brown Health, as well as discussions with physicians statewide, which have illustrated the systematic decline of healthcare services in the state. Neronha pointed out that Brown Health opted to acquire two financially struggling hospitals in Massachusetts rather than reinvest in local healthcare, largely due to more favorable reimbursement rates in that state.

Key Elements of the Strategy

Neronha’s plan outlines two main objectives: enhancing revenue streams into the healthcare system and eliminating unnecessary costs. One of the initial actions taken includes an $11 million settlement with Barletta Heavy Construction, with $10 million allocated specifically to expand dental care services for children in Providence.

Additionally, Neronha’s office has initiated legal action against major Pharmacy Benefit Managers (PBMs), including CVS Caremark, Express Scripts, and Optum, accusing them of manipulating drug prices and misleading consumers. The lawsuit argues that these entities leverage their significant market power in ways that contribute to escalating medication costs.

CVS Health has refuted these claims, maintaining that it actively benefits the Rhode Island economy and has previously enacted cost-saving measures for consumers.

Legislative Proposals

To further tackle the crisis, proposed legislation seeks to raise Medicaid payment rates for primary care providers, aligning them with those of Medicare. The attorney general is also advocating for the Rhode Island Prior Authorization Reform Act of 2025, aimed at removing prior authorization requirements that hinder healthcare delivery for primary care physicians.

In response to recent hospital closures, including those affecting 25,000 patients due to the shutdown of Anchor Medical Associates practices, Neronha is seeking the authority to petition the court for receivership of financially distressed medical facilities. He is also exploring regulations requiring notification to his office regarding transactions involving medical practice consolidations, especially those driven by private equity interests.

Addressing Technology and Transparency

The attorney general is contemplating regulations concerning the use of artificial intelligence in healthcare, acknowledging its rapid implementation and potential effects on patient care and healthcare delivery. His office is collaborating with Brown University’s Center for Advancing Health Policy to assess various options for statewide healthcare reform, including the opportunity to establish a state-based universal health system.

Neronha has proposed creating a dedicated state healthcare agency intended to focus on data analysis and long-term strategic planning for medical services in Rhode Island. In a noteworthy step, he launched a new website titled “A Way Forward,” which outlines his reform initiatives aimed at restructuring the state’s healthcare framework.

Criticism of Current Reforms

Although some efforts have been made by Governor Dan McKee’s administration to address issues related to Medicaid reimbursement and primary care funding, Neronha has criticized these attempts as insufficient, labeling them an “unimpressive attempt” to confront the state’s healthcare challenges. The governor’s administration acknowledges the need for data-driven decisions but recognizes the ongoing nature of the crisis.

Anticipating significant changes ahead, Neronha plans to roll out a comprehensive healthcare reform proposal before the 2026 legislative session, which will encompass initiatives focused on primary care, hospital receivership, and reducing regulatory hurdles for healthcare providers.

Deeper Dive: News & Info About This Topic

• WPRI: Neronha Announces Steps to Address RI’s Health Care Crisis
• Providence Journal: Neronha Releases Initiatives Aimed at Improving Health Care in RI
• Rhode Island Current: Neronha Outlines Fix for R.I.’s Broken Health Care System
• GoLocalProv: As RI’s Healthcare Begins to Collapse
• Encyclopedia Britannica: Medicare