Rhode Island General Laws Title 40. Human Services § 40-8.2-21. Suspension of payments to a provider

(1) The provider does not meet certification requirements of the Rhode Island Medicaid program; or

(2) The Rhode Island Medicaid program has been unable to collect (or make satisfactory arrangements for the collection of) amounts due on account of overpayments to any provider; or

(3) The office of program integrity and/or the Medicaid fraud control unit of the attorney general's office has been unable to obtain, from a provider, the data and information necessary to enable it to determine the existence or amount (if any) of the overpayments made to a provider; or

(4) The office of program integrity or the Medicaid fraud control unit of the attorney general's office has been denied reasonable access to information by a provider that pertains to a patient or resident of a long-term residential-care facility or to a former patient or resident of a long-term residential-care facility; or

(5) The office of program integrity and/or the Medicaid fraud control unit of the attorney general's office has been denied reasonable access to data and information by the provider for the purpose of conducting activities as described in § 1903(g) of the Social Security Act, 42 U.S.C. § 1396b(g); or

(6) The office of program integrity has been presented with reliable evidence that the provider has engaged in fraud or willful misrepresentation under the Medicaid program.