reglab/housing_qa huggingface dataset:
RI Gen L § 40-8-20.1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-20.1 - Prospective rate increments.

§ 40-8-20.1. Prospective rate increments.The department may consider the granting of a prospective rate that reflects demonstrated cost increases in excess of the rate that has been established by the application of the percentage increase. In order to qualify for the rate increment, demonstrated increased costs must be the result of:(1) Demonstrated errors made during the rate-determination process;(2) Significant increases in operating costs resulting from the implementation of new or additional programs, services, or staff specifically mandated by the Rhode Island department of health;(3) Significant increases in operating costs resulting from capital renovations, expansion, or replacement required for compliance with fire safety codes and/or certification requirements of the Rhode Island department of health, as well as increased energy costs that the facility can demonstrate are a result of the facility having expended funds for heating, lighting, hot water, and similar costs associated with the consumption of energy provided by public utilities;(4) Significant increases in workers' compensation and/or health insurance premiums that cannot be accommodated within the nursing facility's assigned aggregate per diem rate, if cost justified; provided, that the assigned per diem rate in the labor- and payroll-related-expenses cost center does not exceed two percent (2%) of the cost center ceiling; or(5) Extraordinary circumstances, including, but not limited to, acts of God, and inordinate increases in energy costs (e.g., federal BTU tax, regional or national energy crisis). Inordinate increases in energy costs will be immediately reflected in increased rates above the energy cost center ceiling maximum. Provided, however, that the increases will be rescinded immediately upon cessation of the extraordinary circumstance. All requests for rate increments shall be limited to one request per nursing facility for the factors set forth in subsections (2) and (3); provided, additional requests involving a per diem increase in excess of one percent of the nursing facility's previously assigned aggregate per diem rate shall also be reviewed. Before a nursing facility shall be permitted to file for a rate increment, increases in operating costs set forth in subsections (2) and (3) must have been incurred for a period of not less than three (3) months in order to establish proof of the increase. Rate adjustments granted as a result of a request filed within one hundred twenty (120) days after the costs were first incurred shall be made effective retroactively to the date the costs were actually incurred; provided, further, any adjustments granted as a result of requests filed more than one hundred twenty (120) days after the costs were first incurred will be effective on the first day of the month following the filing of the request.History of Section.P.L. 2006, ch. 246, art. 15, § 2; P.L. 2007, ch. 73, art. 12, § 1.
RI Gen L § 40-8-20.2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-20.2 - Best energy practices for licensed nursing facilities - Energy conservation retention credit.

§ 40-8-20.2. Best energy practices for licensed nursing facilities — Energy conservation retention credit.(a) In order to reduce overall energy consumption and to slow the rate of the growth in state Medicaid expenditures, the state of Rhode Island shall adopt an energy conservation retention credit for licensed nursing facilities that meet the criteria set forth herein. Every licensed nursing facility participating in the Medicaid medical assistance program that: (1) Expends funds for energy conservation measures and the use of renewable fuels, energy sources, and so-called "green" sources of energy that result in a reduction of energy consumption; and (2) Which methods the facility can demonstrate, to the satisfaction of the department, result in the facility's "pass through" per diem cost being reduced in the next base year in comparison to the immediately preceding base year, shall be permitted to retain the difference in the previous per diem and the new per diem for a period of up to twenty-four (24) months. Provided, that such retained funds shall be utilized by the nursing facility solely for either: (1) Costs directly associated with employing labor at the facility; or (2) To pay down any debt of the nursing facility incurred directly through the purchases of energy saving, conservation, and renewable energy or so-called "green" devices.(b) The department of human services shall convene a working group of interested parties, including, but not limited to, public utilities, provider trades associations, labor unions representing nursing home employees, and environmental advocates, to establish best energy practices for this industry.History of Section.P.L. 2007, ch. 73, art. 12, § 2.
RI Gen L § 40-8-21 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-21 - Appeals process.

§ 40-8-21. Appeals process.(a) Any provider that is not in agreement, after being provided an exit-audit conference or rate-appeal conference, with a final rate of reimbursement assigned as a result of an audit for its base year, or with the application of the principles of reimbursement for an applicable year, may within fifteen (15) days from the date of notification of audit results or rate assignment, file a written request with the department for a review of the computation of the assigned rate. The foregoing right of appeal shall also apply to demonstrated errors made during the rate determination process.(b) A review conference will be conducted within fifteen (15) days from the date of receipt of the written request by a designee assigned by the director of the department of human services. As a result of the review conference, the designee may modify the audit adjustments and/or the rate of reimbursement. The designee shall provide the facility with a written decision within thirty (30) days from the date of the review conference.(c) Appeals beyond the review conference shall be in accordance with the provisions of chapter 35 of title 42. The facility shall file a written request for the hearing no later than fifteen (15) days after receipt of the review conference decision.History of Section.P.L. 1993, ch. 138, art. 20, § 1; P.L. 2003, ch. 376, art. 41, § 3.
RI Gen L § 40-8-22 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-22 - Protection of resources - Long-term care insurance partnership program.

§ 40-8-22. Protection of resources — Long-term care insurance partnership program.(a) The department of human services shall coordinate a program entitled the Rhode Island Partnership for Long-Term Care whereby private insurance and funds may be utilized to finance long-term care. The department shall seek appropriate amendments to its state plan for medical assistance under Title XIX, 42 U.S.C. § 1396 et seq., of the Social Security Act (Medicaid), or waivers of state plan requirements, to allow protection of resources and income pursuant to this section. The protection shall be provided, to the extent approved by the federal Centers for Medicare and Medicaid Services, for any purchaser of a precertified, long-term-care policy delivered, issued for delivery, or renewed and shall last for the life of the purchaser. Notwithstanding any provision of the general laws, the resources of an individual, to the extent the resources are equal to the amount of qualifying long-term-care insurance benefits payments provided pursuant to a policy of long-term-care insurance precertified in accordance with department regulations and chapter 34.2 of title 27, shall not be considered by the department in a determination of: (1) His or her eligibility for Medicaid; (2) The amount of any Medicaid payment; or (3) In any subsequent recovery by the state of a payment for medical services. The precertified policies shall be known as "Medicaid qualifying long-term care partnership policies."(b) The department shall count insurance benefit payments toward resource exclusion to the extent the payments: (1) Are for services covered under the state plan for medical assistance, including nursing home care, or formal services delivered to insureds in the community as part of a care plan; (2) Are for the lower of the actual charge or the amount paid by the insurance company; and (3) Are for services provided after the individual meets the coverage requirements for long-term-care benefits established by the department for this program. The department shall adopt rules and regulations to implement the provisions of this section and relating to determining eligibility of applicants for Medicaid and the coverage requirements for long-term-care benefits.History of Section.P.L. 1993, ch. 454, § 1; P.L. 2007, ch. 239, § 4.
RI Gen L § 40-8-23 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-23 - Contracting standards.

§ 40-8-23. Contracting standards.The director shall establish and maintain contracting standards for home health aide, homemaker, and nursing services. These standards shall apply to all such services purchased by the state from licensed providers. The contracting standards shall take into consideration industry guidelines published by national accreditation organizations such as the Joint Commission for the Accreditation of Healthcare Organizations and self-reporting activities by providers.History of Section.P.L. 1996, ch. 341, § 1.
RI Gen L § 40-8-24 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-24 - Less expensive alternative medications.

§ 40-8-24. Less expensive alternative medications.For pharmaceutical purchases eligible for reimbursement under the Medicaid state plan, the department shall encourage the substitution of generic drugs which are therapeutically equivalent and interchangeable with specific brand name drugs in accordance with § 21-31-16.1 and related regulations of the department of health, except in the event that a brand name is determined by the director to be less costly to the state than the equivalent generic. Calculation of comparative drug costs shall include consideration of the amount paid by the state to the pharmacy for a drug under the current retail pharmacy reimbursement formula, less any discounts or rebates, including those paid pursuant to federal Medicaid law during the previous calendar quarter, and inclusive of all dispensing fees.History of Section.P.L. 2002, ch. 65, art. 24, § 1; P.L. 2004, ch. 416, § 1; P.L. 2004, ch. 552, § 1.
RI Gen L § 40-8-25 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-25 - Nursing facility pharmaceutical waste reduction.

§ 40-8-25. Nursing facility pharmaceutical waste reduction.The department shall implement one or more methods to reduce the disposal of unused pharmaceuticals paid for by the medical assistance program for residents of nursing facilities licensed pursuant to chapter 17 of title 23. The department shall make a report to the permanent joint legislative committee on health care oversight on or before March 1, 2005, regarding the methods employed and any resulting cost savings anticipated.History of Section.P.L. 2004, ch. 282, § 1; P.L. 2004, ch. 465, § 1.
RI Gen L § 40-8-27 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-27 - Cooperation by providers.

§ 40-8-27. Cooperation by providers.Medicaid providers who employ individuals applying for benefits under any chapter of this title shall comply in a timely manner with requests made by the department for any documents describing employer-sponsored health insurance coverage or benefits the provider offers that are necessary to determine eligibility for the state's premium assistance program pursuant to § 40-8.4-12. Documents requested by the department may include, but are not limited to, certificates of coverage or a summary of benefits and employee obligations. Upon receiving notification that the department has determined that the employee is eligible for premium assistance under § 40-8.4-12, the provider shall accept the enrollment of the employee and his or her family in the employer-based health insurance plan without regard to any seasonal enrollment restrictions, including open-enrollment restrictions, and/or the impact on the employee's wages. Additionally, the Medicaid provider employing such persons shall not offer "pay in lieu of benefits." Providers who do not comply with the provisions set forth in this section shall be subject to suspension as a participating Medicaid provider.History of Section.P.L. 2008, ch. 100, art. 17, § 7.
RI Gen L § 40-8-28 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-28 - Vendors doing business in the state of Rhode Island.

§ 40-8-28. Vendors doing business in the state of Rhode Island.All vendors who do business with the state of Rhode Island in accordance with title 37 and who are also employers of Rhode Island medical assistance recipients shall make available in a timely manner to the department at the department's request, documents describing the health insurance or health benefits offered by the vendor to the employee, including, but not limited to, a certificate of coverage or a summary of benefits and employee obligations for the purposes of, and only to the extent necessary to carry out the provisions of this section of the general laws. The employer shall accept the enrollment of the individual and/or the family in the employer-based health insurance plan without regard to any seasonal enrollment restrictions, including open-enrollment restrictions, without regard to the impact on the member's wages. This is known as "pay in lieu of benefits."History of Section.P.L. 2008, ch. 100, art. 17, § 7.
RI Gen L § 40-8-29 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-29 - Selective contracting.

§ 40-8-29. Selective contracting.(a) Notwithstanding any other provision of state law, the department of human services is authorized to utilize selective contracting with prior general assembly approval for the purpose of purchasing for Medicaid recipients shared-living provider services, durable medical equipment and supplies, non-emergency transportation, and any other Medicaid services, when appropriate, in order to ensure that all service expenditures under this chapter have the maximum benefit of competition, and afford Rhode Islanders the overall best value, optimal quality, and the most cost-effective care possible. Beneficiaries will be limited to using the services/products of only those providers determined in a competitive bidding process to meet the standards for best quality, performance, and price set by the department in accordance with applicable federal and state laws.(b) For purposes of this section, "selective contracting" shall mean the process for choosing providers to serve Medicaid beneficiaries based on their ability to deliver the best quality products or services, at the best value or price.(c) To ensure all services allowable for Medicare reimbursement for beneficiaries who are dually eligible, selective contractors must be willing and able to accept Medicare.History of Section.P.L. 2008, ch. 100, art. 17, § 7; P.L. 2009, ch. 68, art. 22, § 4; P.L. 2009, ch. 68, art. 23, § 2; P.L. 2009, ch. 69, § 4; P.L. 2010, ch. 23, art. 20, § 1.
RI Gen L § 40-8-30 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-30 - Suspension of participating providers.

§ 40-8-30. Suspension of participating providers.Any approved medical assistance provider who declines to participate in contracting for benefits in any one of the department's medical assistance programs, including, but not limited to, any and all managed care programs, may be suspended as a participating provider and denied participation in all state-operated medical assistance programs at the discretion of the department. Prior to suspension, a participating provider shall have the right to appeal such suspension to a state administrative hearing officer, in accordance with the rules of the department of human services.History of Section.P.L. 2009, ch. 68, art. 22, § 5; P.L. 2009, ch. 69, § 5.
RI Gen L § 40-8-31 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-31 - Payments to out-of-state facilities.

§ 40-8-31. Payments to out-of-state facilities.Effective September 1, 2014, the executive office of health and human services shall require that any payment to an out-of-state provider from whom a Medicaid-eligible individual receives services must be a facility that applies for, and is approved to participate in, the Rhode Island Medicaid program. This excludes payments to out-of-state providers that do not participate in the Rhode Island Medicaid program but that are determined to be acceptable due to extenuating circumstances by the secretary of the executive office of health and human services. Furthermore, the department of children, youth and families is required to submit a bi-weekly report to the chair of the house committee on finance, the chair of the senate committee on finance, the house fiscal advisor, the senate fiscal advisor, and the office of management and budget detailing payments for placements to out-of-state facilities. The report should also indicate the entity recommending or ordering the placement, the types of services required, and reason for using an out-of-state facility. This change may require the adoption of new or amended rules, regulations and procedures.History of Section.P.L. 2014, ch. 145, art. 18, § 2.
RI Gen L § 40-8.1-1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.1 - Personal Care Attendant Program|Section 40-8.1-1 - Authority to establish program - Administration.

§ 40-8.1-1. Authority to establish program — Administration.The department of human services is hereby authorized to establish a participant-directed personal care attendant program for those with severe physical disabilities, to provide personal attendant care to those disabled individuals who meet certain eligibility criteria hereinafter stated. The department of human services shall be responsible for the administration of the program but may contract with other state agencies or nonprofit organizations in connection with the program.History of Section.P.L. 1979, ch. 122, § 1.
RI Gen L § 40-8.1-2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.1 - Personal Care Attendant Program|Section 40-8.1-2 - Services provided.

§ 40-8.1-2. Services provided.Services that may be provided eligible persons if not available from other sources include:(1) Any appropriate vocational rehabilitation service, as well as other services that will enhance the ability of individuals with disabilities to live independently and function within the family and community;(2) Personal care attendant services;(3) Advocacy services;(4) Peer counseling;(5) Housing; and(6) Transportation.History of Section.P.L. 1979, ch. 122, § 1; P.L. 1999, ch. 83, § 98; P.L. 1999, ch. 130, § 98.
RI Gen L § 40-8.1-3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.1 - Personal Care Attendant Program|Section 40-8.1-3 - Eligibility for services.

§ 40-8.1-3. Eligibility for services.Services available under this chapter may be provided to any person who meets the following criteria:(1) Has made application therefor to the director of the department of human services in a manner prescribed by the director;(2) Has a severe physical disability that caused the person to be unduly dependent, the disability to be certified by the division of vocational rehabilitation; and(3) Has not sufficient income or resources to meet the cost of home-care services, a determination of insufficiency to be made by the division of vocational rehabilitation.History of Section.P.L. 1979, ch. 122, § 1.
RI Gen L § 40-8.1-4 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.1 - Personal Care Attendant Program|Section 40-8.1-4 - When services may be provided.

§ 40-8.1-4. When services may be provided.Personal care attendant services may be provided when:(1) The requirements of § 40-8.1-3 are met; and(2) An attendant is available to provide the care needed.History of Section.P.L. 1979, ch. 122, § 1.
RI Gen L § 40-8.1-5 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.1 - Personal Care Attendant Program|Section 40-8.1-5 - Appropriations.

§ 40-8.1-5. Appropriations.There is hereby appropriated to the department of human services funds adequate to implement an independent-living program, including a participant-directed personal care attendant program, in the amount of ninety-five thousand dollars ($95,000) for fiscal year ending June 30, 1980. Additional funds shall be made available on a yearly basis to maintain the program.History of Section.P.L. 1979, ch. 122, § 1.
RI Gen L § 40-8.2-1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.2 - Medical Assistance Fraud|Section 40-8.2-1 - Short title.

§ 40-8.2-1. Short title.This chapter shall be known as the "Rhode Island Medical Assistance Fraud Law."History of Section.P.L. 1982, ch. 424, § 1.
RI Gen L § 40-8.2-4 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.2 - Medical Assistance Fraud|Section 40-8.2-4 - Statute of limitations.

§ 40-8.2-4. Statute of limitations.The statute of limitations for any violation of the provisions of this chapter shall be ten (10) years.History of Section.P.L. 1989, ch. 501, § 3.
RI Gen L § 40-8.2-5 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.2 - Medical Assistance Fraud|Section 40-8.2-5 - Civil remedy.

§ 40-8.2-5. Civil remedy.Any person, including the secretary of the executive office of health and human services or the office of program integrity acting on behalf of the secretary of the office, injured by any violation of the provisions of § 40-8.2-3 or § 40-8.2-4 may recover through a civil action from the persons inflicting the injury three (3) times the amount of the injury.History of Section.P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.
RI Gen L § 40-8.2-7 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.2 - Medical Assistance Fraud|Section 40-8.2-7 - False statements made to gain certification.

§ 40-8.2-7. False statements made to gain certification.Whoever knowingly and willfully makes, or causes to be made, or induces, or seeks to induce, the making of any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that the institution or facility may qualify (either upon initial certification or upon recertification) as a hospital, skilled nursing facility, intermediate-care facility, or home health agency, shall be guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than five hundred dollars ($500) or imprisoned for not more than six (6) months, or both.History of Section.P.L. 1982, ch. 424, § 1.