“Medicaid MAGI Financial Eligibility Determinations and Verification” (210-RICR-30-00-5)


210-RICR-30-00-5 ACTIVE RULE

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5.1Scope and Legal Authority

5.2Incorporated Materials

5.3Definitions

5.4MAGI Household Construction

5.5Exceptions Requiring Application of Relationship Household Rules

5.6Determination of Household Income

5.7Verification of Income Using the MAGI Methodology

5.8Verification Process

5.9Medicaid Reasonable Compatibility Standards

5.10Reasonable Explanations

5.11Reconciliation Period

5.12Satisfactory Documentation and Alternative Forms of Verification

5.13Post-Eligibility Verification (PEV) by the Integrated Eligibility System (IES)


Title 210 Executive Office of Health and Human Services
Chapter 30 Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 00 Affordable Coverage Groups
Part 5 “Medicaid MAGI Financial Eligibility Determinations and Verification” (210-RICR-30-00-5)
Type of Filing Amendment
Regulation Status Active
Effective 08/28/2025

Regulation Authority:

Chapters 40-6 and 40-8 of the Rhode Island General Laws
as amended; Title XIX of the Social Security Act
42 CFR 435.945(k)
IRS Publication 17

Purpose and Reason:

Regulations are being revised to reflect the State's use of commercially available data sources and the removal of the tuition and fees deduction by the Internal Revenue Service (IRS).

Rulemaking Documents are organized by document type and are part of this rule’s rulemaking record (R.I. Gen. Laws § 42-35-2.3). If multiple documents of the same type are listed below, each is a unique document. If there are multiple Public Notice of Proposed Rulemaking documents, view each document to identify the most recently amended version, as it may be amended at any point during the Public Comment Period.