The Rhode Island Department of Health receives Medicaid reimbursement for initial lead inspections for Medicaid-eligible children with significant lead poisoning. The rate is set at $775 per inspection, with the State receiving 54% ($418) in Federal funds and providing the remaining 46% as a match. Originally, this rate was established by first calculating the total sum of the personnel, equipment and laboratory costs in the inspection program. This was multiplied by the fraction of the total costs representing the initial inspections. Lastly, a multiplier representing the percentage of Medicaid-eligible children served by the program was applied.
Services in this agreement include: contacting families to schedule inspections, including interpreting services; Comprehensive Environmental Lead Inspections by RI Licensed Lead Inspectors assisted by technicians, including site investigation, laboratory analysis of 20-30 samples and reporting; and inspection review.
Several years after this fee structure was established, the State privatized lead inspections. Private inspectors accomplish all services except inspection review, which is performed by program staff. Each task in an inspection was assigned a typical performance time. Based on an hourly rate of $50 per hour, the original rate was supported, providing $675 to private inspectors and $100 to the program.
Learning Objectives: At the conclusion of this session, participants will be able to develop a proposal for Medicaid reimbursement for Environmental Lead Inspections for Medicaid-eligible children with lead poisoning
Keywords: Lead, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.