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Rhode Island General Laws Title 40. Human Services § 40-8.8-7. Regulations and commencement of program

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) The department of human services shall submit the Medicaid state plan amendment and promulgate any rules or regulations necessary to implement the provisions of this chapter, contingent upon, and immediately following, federal approval of any program of all-inclusive care of the elderly.

(b) Contingent upon completion of the Medicaid state plan amendment process, and the appropriation of necessary funding to implement the program, the program of all-inclusive care for the elderly shall commence on July 1, 2005.

(c) Each hospital licensed in this state under chapter 17 of title 23 must accept as payment in full for providing professional component, technical component, or globally billed services to a person enrolled in a program of all-inclusive care for the elderly no more than one hundred percent (100%) of what Medicare would pay the hospital for providing the same services.

(d) A hospital-owned or controlled professional practice or affiliate thereof must accept as payment in full for providing professional services to a person enrolled in a program of all-inclusive care for the elderly no more than one hundred percent (100%) of what Medicare would pay the relevant professional for providing the same services.

(e) For purposes of subsection (d):

(1) A “ hospital-owned or controlled professional practice” means a practitioner's (physician, dentist, or other healthcare provider) office or group of practitioners' offices (whether organized as a nonprofit corporation, professional service corporation, partnership, organization, or association) that is directly or indirectly owned or controlled by a hospital licensed under chapter 17 of title 23, or is directly or indirectly owned or controlled by an affiliate of such a hospital; and

(2) An “ affiliate” means an entity that is controlled by, in control of, or in common control with, another entity.

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Cite this article: FindLaw.com - Rhode Island General Laws Title 40. Human Services § 40-8.8-7. Regulations and commencement of program - last updated January 01, 2024 | https://codes.findlaw.com/ri/title-40-human-services/ri-gen-laws-sect-40-8-8-7/

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