MEDICAL ASSISTANCE PROGRAM - Section 0378 - Institutional Care

Regulation Authority:

RIGL 40-8; Title XIX of the Social Security Act

Purpose and Reason:

A Category II change request to the Rhode Island Global Choice Compact Waiver, with an effective date of February 1, 2010, has been submitted to Centers for Medicare and Medicaid Services (CMS) regarding proposed rate setting for nursing facility services. The current State Plan and DHS rule Medical Assistance have been revised to include an adjustment to facility rates based on the acuity of the Medicaid residents of the facility. Acuity is defined as the relative need for nursing care. DHS proposes to increase or decrease nursing facility per diem rates, depending on how individual facility nursing costs and patient acuity compare to statewide averages.