Governor’s budget would add primary care to state rate review; advocates urge broader scope

A proposal in Gov. McKee’s fiscal 2026 budget to include primary care in the Office of the Health Insurance Commissioner’s biennial social and human services rate review drew support and technical questions at a Feb. 27 hearing of the Senate Finance Committee.

The provision (Article 8, section 8 of the proposed budget, cited in testimony as H5076 Article 8 Section 8) would direct OHIC to review primary care provider rates as part of its next scheduled rate-review cycle, with the report currently scheduled for the September 2027 cycle.

Supporters said the review is a needed first step to address shortages in pediatric and primary care, particularly for Medicaid enrollees. "We love the idea of having OHIC conduct a rigorous review," said Sam Salganek, executive director of Riipen, a statewide social-service nonprofit whose board and staff include parents of children with disabilities. "Primary care is actually quite different than social and human services," Salganek added, urging changes to how the review handles payor mix and payment methodologies.

Mikaela Carroll, health policy associate at Rhode Island Kids Count, told the committee that pediatric primary care is in crisis: "More…