Medicaid Payments and Providers (formerly Medicaid Code of Administrative Rules, Section #0301) (210-RICR-20-00-1)


210-RICR-20-00-1 ACTIVE RULE

My Page Title

1.1Legal Authority

1.2Definitions

1.3Medicaid Payment Policy

1.4Long-term Care Facilities – Surveys

1.5Medicaid Provider Administrative Sanctions

1.6Notice of Violations and Sanctions

1.7Severability


Title 210 Executive Office of Health and Human Services
Chapter 20 Medicaid Payments and Providers
Subchapter 00 N/A
Part 1 Medicaid Payments and Providers (formerly Medicaid Code of Administrative Rules, Section #0301) (210-RICR-20-00-1)
Type of Filing Direct Final Amendment
Regulation Status Active
Effective 03/17/2022

Regulation Authority:

Chapters 40-6 and 40-8 of the Rhode Island General Laws
as amended; Title XIX of the Social Security Act

Purpose and Reason:

The amendment clarifies the requirement for the State to apply cost avoidance procedures for prenatal services including labor, delivery and postpartum care and provides for an exception to Medicaid as the payor of last resort in the case of pediatric preventive services, unless the state has made a determination related to cost-effectiveness and access to care that warrants cost avoidance for 90 days. The amendment also allows the State to make payments without regard to potential third party liability for up to one hundred (100) days for claims related to child support enforcement beneficiaries.