H 8171

2026 -- H 8171 SUBSTITUTE A
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LC005424/SUB A
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  STATE  OF        RHODE  ISLAND
  IN GENERAL ASSEMBLY
  JANUARY SESSION, A.D. 2026
  ____________
  AN ACT
   RELATING TO HEALTH AND SAFETY -- FOOD-AS-MEDICINE PILOT PROGRAM
  Introduced By: Representatives Caldwell, Slater, Kislak, and Spears
  Date Introduced: February 27, 2026
  Referred To: House Finance
It is enacted by the General Assembly as follows:
1SECTION 1. The general assembly finds and declares that:
2(1) Diet-related chronic diseases, including diabetes, cardiovascular disease, hypertension,
3 and obesity, represent a significant and growing burden on Rhode Island’s residents and healthcare
4 system;
5(2) Individuals experiencing food insecurity and chronic illness often face barriers to
6 accessing nutritious food that supports disease prevention and management;
7(3) Evidence-based food-as-medicine interventions, including medically tailored meals
8 and nutrition supports, have demonstrated in a number of states nationwide the potential to improve
9 health outcomes, reduce health disparities, and lower healthcare utilization and costs for high-risk
10 populations;
11(4) Healthcare delivery systems are increasingly transitioning to value-based purchasing
12 and whole-person care models that emphasize prevention and the integration of health-related
13 social needs; and
14(5) A carefully scoped pilot program, developed in collaboration with health insurers and
15 community-based service providers, is necessary to determine the feasibility, effectiveness, and
16 sustainability of food-as-medicine interventions in Rhode Island.
17SECTION 2. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby
18 amended by adding thereto the following chapter:
19CHAPTER 106
1FOOD-AS-MEDICINE PILOT PROGRAM
223-106-1. Food-as-medicine task force -- Establishment.
3(a) The food-as-medicine task force is hereby established within the executive office of
4 health and human services (EOHHS) for the purpose of developing recommendations for the
5 creation and implementation of a food-as-medicine pilot program in Rhode Island.
6(b) The task force shall consist of the following members, or designees:
7(1) The secretary of the EOHHS;
8(2) The director of the department of health;
9(3) The director of the office of healthy aging;
10(4) The director of the department of human services;
11(5) The health insurance commissioner;
12(6) A representative from a community health center;
13(7) A representative from a managed Medicaid insurer providing medically tailored meals;
14(8) A representative from a commercial healthcare insurer providing medically tailored
15 meals;
16(9) A representative from a hospital system engaged in value-based care initiatives;
17(10) A representative of an academic institution with research or evaluation expertise;
18(11) A representative of a not-for-profit medically tailored meal provider;
19(12) A general physician or advanced practice nurse with experience serving persons with
20 chronic illness;
21(13) A licensed registered dietitian nutritionist;
22(14) One member of the Rhode Island house of representatives from the majority party,
23 appointed by the speaker of the house;
24(15) One member of the Rhode Island house of representatives from the minority party,
25 appointed by the minority leader of the house;
26(16) One member of the Rhode Island senate from the majority party, appointed by the
27 senate president;
28(17) One member of the Rhode Island senate from the minority party, appointed by the
29 senate minority leader; and
30(18) One public member representing the interests of individuals managing chronic illness.
31(c) Members shall serve without compensation.
3223-106-2. Duties of the task force.
33(a) The task force shall examine and make recommendations regarding the design, scope,
34 and implementation of a food-as-medicine pilot program in Rhode Island including, but not limited
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1 to the following:
2(1) Identifying specific populations that experience a disproportionate burden of diet-
3 related chronic disease and are most likely to benefit from food-as-medicine interventions
4 including, but not limited to, individuals enrolled in Medicaid, older adults, and individuals with
5 complex medical needs;
6(2) Defining appropriate eligibility criteria for participation in a food-as-medicine pilot
7 program to ensure the efficient and effective targeting of limited resources;
8(3) Identifying evidence-based food-as-medicine interventions to be included in the pilot
9 program including, but not limited to, medically tailored meals and other nutrition-based supports;
10(4) Assessing opportunities for collaboration with community-based service providers,
11 health care providers, managed care organizations, and commercial insurers in the delivery of food-
12 as-medicine interventions;
13(5) Evaluating options for reimbursement, payment models, and financing mechanisms,
14 including Medicaid authorities, value-based purchasing arrangements, and public-private
15 partnerships;
16(6) Examining data collection, evaluation, and reporting requirements necessary to assess
17 health outcomes, utilization, cost impacts, and health equity implications of the pilot program;
18(7) Identifying administrative, operational, or regulatory barriers to implementation of a
19 food-as-medicine pilot program in Rhode Island;
20(8) Developing recommendations for legislative, regulatory, or budgetary actions
21 necessary to establish and sustain a food-as-medicine pilot program;
22(9) Examining the feasibility of utilizing federal Medicaid authorities and federal grant
23 programs including, but not limited to, a federal rural health grant program or a waiver or
24 amendment under section 1115 of the Social Security Act, to support the design, implementation,
25 and evaluation of a food-as-medicine pilot program;
26(10) Identifying the populations, services, delivery models, and outcome measures that
27 could be included in an application for a federal rural health grant program or a section 1115 waiver
28 or waiver amendment to support food-as-medicine interventions for individuals with the highest
29 burden of diet-related chronic disease; and
30(11) Assessing the alignment of a food-as-medicine pilot program with existing Medicaid
31 managed care, value-based purchasing, and health equity initiatives administered by the executive
32 office of health and human services.
3323-106-3. Meetings and staffing.
34(a) The secretary of the executive office of health and human services (EOHHS), or
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1 designee, shall convene the first meeting of the task force no later than ninety (90) days after the
2 effective date of this chapter.
3(b) The EOHHS, or such department, office, or program with relevant subject‑matter
4 expertise as designated by the secretary, shall provide staff support to the task force.
523-106-4. Reporting.
6(a) The task force shall submit a report of its findings and recommendations to the
7 governor, the speaker of the house of representatives, and the president of the senate.
8(b) The report shall include recommendations regarding the scope, design, and
9 implementation of a food-as-medicine pilot program including, but not limited to, any proposed
10 legislation necessary to authorize or fund the pilot program.
11(c) The report shall be submitted no later than December 31, 2026.
1223-106-5. Medicaid waiver authority -- Food-as-medicine pilot.
13(a) The executive office of health and human services (EOHHS) is authorized to seek
14 federal approval to implement a food-as-medicine pilot program for eligible Medicaid
15 beneficiaries.
16(b) For the purposes of this section, the EOHHS may submit an application for, or
17 amendment to, a demonstration project pursuant to section 1115 of the Social Security Act, or
18 pursue other available federal Medicaid authorities, as necessary to implement and fund the food-
19 as-medicine pilot program.
20(c) The application for a section 1115 waiver or waiver amendment may include, but is not
21 limited to:
22(1) Coverage of evidence-based food-as-medicine interventions including, but not limited
23 to, medically tailored meals and other nutrition-based supports, for Medicaid beneficiaries with
24 chronic, diet-related diseases;
25(2) Eligibility criteria designed to prioritize individuals with the highest health risks, health
26 care utilization, and unmet nutrition-related needs;
27(3) Delivery models that leverage partnerships with community-based service providers,
28 health care providers, and managed care organizations;
29(4) Payment and reimbursement methodologies consistent with value-based purchasing
30 principles; and
31(5) Data collection, evaluation, and reporting requirements to assess health outcomes,
32 health equity, utilization, and cost impacts.
33(d) The EOHHS may implement the food-as-medicine pilot program upon receipt of any
34 necessary federal approvals and subject to the availability of federal financial participation.
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123-106-6. Construction.
2Nothing in this act shall be construed to require state expenditures beyond those authorized
3 through federal approval, existing appropriations, or future legislative action.
4SECTION 3. This act shall take effect upon passage.
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  EXPLANATION
  BY THE LEGISLATIVE COUNCIL
  OF
  AN ACT
  RELATING TO HEALTH AND SAFETY -- FOOD-AS-MEDICINE PILOT PROGRAM
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1This act would establish a food-as-medicine pilot program and task force to be
2 administered by the executive office of health and human services.
3This act would take effect upon passage.
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