§ 40-8-1. Declaration of policy. (a) Whereas, in the state of Rhode Island there are many persons who do not have sufficient income and resources to meet the cost of medical care and who, except for income and resource requirements, would be eligible for aid or assistance under § 40-5.1-9 [repealed] or § 40-6-27; and […]
§ 40-8-10. Recovery of benefits paid in error. Any person, who through error or mistake of himself or herself or another, receives medical care benefits to which he or she is not entitled or with respect to which he or she was ineligible, shall be required to reimburse the state for the benefits paid through […]
§ 40-8-11. Civil action to recover benefits. Any sums required to be reimbursed to the state under the provisions of § 40-8-10 and any benefits obtained by false statement or misrepresentation may be collected by civil action. All civil actions shall be instituted in the name of the director, and he or she shall be […]
§ 40-8-12. Federal approval. (a) The department is empowered and authorized to submit its plan for medical assistance to the federal government, or any agency or department thereof having funds available for medical care benefits provided for in this chapter, for approval pursuant to the provisions of the federal Social Security Act, 42 U.S.C. § […]
§ 40-8-13. Rules, regulations, and fee schedules. The director shall make and promulgate rules, regulations, and fee schedules not inconsistent with state law and fiscal procedures as he or she deems necessary for the proper administration of this chapter and to carry out the policy and purposes thereof, and to make the department’s plan conform […]
§ 40-8-13.1. [Repealed.] History of Section.P.L. 1995, ch. 370, art. 32, § 1; P.L. 2000, ch. 55, art. 12, § 1; P.L. 2006, ch. 216, § 19; P.L. 2009, ch. 5, art. 15, § 1; Repealed by its own terms pursuant to P.L. 2009, ch. 68, art. 23, § 6, effective March 30, 2010.
§ 40-8-13.2. [Repealed.] History of Section.P.L. 2002, ch. 65, art. 33, § 1; P.L. 2007, ch. 73, art. 13, § 2; P.L. 2009, ch. 68, art. 23, § 6; Repealed by its own terms and pursuant to § 40-8-13.4(g), effective March 30, 2010.
§ 40-8-13.3. Payment for services provided by in-state and out-of-state hospitals. The department of human services and/or the secretary of the executive office of health and human services is hereby authorized and directed to amend its rules and regulations and amend the Rhode Island state plan for medical assistance (Medicaid) pursuant to Title XIX of […]
§ 40-8-13.4. Rate methodology for payment for in-state and out-of-state hospital services. (a) The executive office of health and human services (“executive office”) shall implement a new methodology for payment for in-state and out-of-state hospital services in order to ensure access to, and the provision of, high-quality and cost-effective hospital care to its eligible recipients. […]
§ 40-8-13.5. Hospital Incentive Program (HIP). The secretary of the executive office of health and human services is authorized to seek the federal authorities required to implement a hospital incentive program (HIP). The HIP shall provide the participating licensed hospitals the ability to obtain certain payments for achieving performance goals established by the secretary. HIP […]
§ 40-8-14. Appropriations. The general assembly shall annually appropriate a sum as it may deem necessary to carry out the purposes of this chapter, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or sums or so much thereof […]
§ 40-8-15. Lien on deceased recipient’s estate for assistance. (a)(1) Upon the death of a recipient of Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. § 1396 et seq. and referred to hereinafter as the “Act”), the total sum for Medicaid benefits so paid on behalf of a beneficiary who was […]
§ 40-8-16. Notification of long-term care alternative. (a) The department of human services, before authorizing care in a nursing home or intermediate-care facility for a person who is eligible to receive benefits pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and who is being discharged from a […]
§ 40-8-17. Waiver request. (a) Formation. The executive office of health and human services is directed and authorized to apply for and obtain any necessary waiver(s), waiver amendment(s), and/or state plan amendments from the Secretary of the United States Department of Health and Human Services, including, but not limited to, an extension of the section […]
§ 40-8-18. Local education agencies as EPSDT providers. (a) It is the intent of this section to provide reimbursement for early and periodic screening, diagnosis and treatment (EPSDT) services through local education agencies for children who are eligible for medical assistance. A local education agency’s participation as an EPSDT provider is voluntary. Further, it is […]
§ 40-8-19. Rates of payment to nursing facilities. (a) Rate reform. (1) The rates to be paid by the state to nursing facilities licensed pursuant to chapter 17 of title 23, and certified to participate in Title XIX of the Social Security Act for services rendered to Medicaid-eligible residents, shall be reasonable and adequate to […]
§ 40-8-19.1. Nursing facility financial oversight. (a) On an annual basis, every licensed nursing facility participating in the medical assistance program shall file a financial statement or other financial information acceptable to the department with its annual cost report (BM-64) for the time period covered by the cost report that would provide sufficient information for […]
§ 40-8-19.2. Nursing Facility Incentive Program (NFIP). The secretary of the executive office of health and human services is authorized to seek the federal authority required to implement a nursing facility incentive program (NFIP). The NFIP shall provide the participating licensed nursing facilities the ability to obtain certain payments for achieving performance goals established by […]
§ 40-8-2. Definitions. As used in this chapter, unless the context shall otherwise require: (1) “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, palliative treatment, and the refitting and relining of existing dentures and prosthesis. (2) “Department” means the department of human services. (3) “Director” means the director of human services. (4) […]
§ 40-8-20. [Repealed.] History of Section.P.L. 1993, ch. 138, art. 20, § 1; Repealed by P.L. 2003, ch. 376, art. 41, § 2, effective October 1, 2005.
