reglab/housing_qa huggingface dataset:
RI Gen L § 40-8-3.1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-3.1 - Life estate in property - Retained powers.

§ 40-8-3.1. Life estate in property — Retained powers.When an applicant or recipient of Medicaid owns a life estate in property that is his or her principal place of residence with the reserved power and authority, during his or her lifetime, to sell, convey, mortgage, or otherwise dispose of the real property without the consent or joinder by the holder(s) of the remainder interest, the principal place of residence shall not be regarded as an excluded resource for the purpose of Medicaid eligibility, unless the applicant or recipient individually, or through his or her guardian, conservator, or attorney in fact, conveys all outstanding remainder interest to him or herself.An applicant or recipient who, by a deed created, executed and recorded on or before June 30, 2014, has reserved a life estate in property that is his or her principal place of residence with the reserved power and authority, during his or her lifetime, to sell, convey, mortgage, or otherwise dispose of the real property without the consent or joinder by the holder(s) of the remainder interest, shall not be ineligible for Medicaid on the basis of the deed, regardless of whether the transferee of the remainder interest is a person or persons, trust, or entity.History of Section.P.L. 2014, ch. 145, art. 19, § 3.
RI Gen L § 40-8-4 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-4 - Direct vendor payment plan.

§ 40-8-4. Direct vendor payment plan.(a) The department shall furnish medical care benefits to eligible beneficiaries through a direct vendor payment plan. The plan shall include, but need not be limited to, any or all of the following benefits, which benefits shall be contracted for by the director:(1) Inpatient hospital services, other than services in a hospital, institution, or facility for tuberculosis or mental diseases;(2) Nursing services for the period of time as the director shall authorize;(3) Visiting nurse service;(4) Drugs for consumption either by inpatients or by other persons for whom they are prescribed by a licensed physician;(5) Dental services; and(6) Hospice care up to a maximum of two hundred and ten (210) days as a lifetime benefit.(b) For purposes of this chapter, the payment of federal Medicare premiums or other health insurance premiums by the department on behalf of eligible beneficiaries in accordance with the provisions of Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., shall be deemed to be a direct vendor payment.(c) [Deleted by P.L. 2021, ch. 162, art. 12, § 2.](d) [Deleted by P.L. 2021, ch. 162, art. 12, § 2.](e) No state agency shall pay a vendor for medical benefits provided to a recipient of assistance under this chapter until and unless the vendor has submitted a claim for payment to a commercial insurance plan, Medicare, and/or a Medicaid managed care plan, if applicable for that recipient, in that order. This includes payments for skilled nursing and therapy services specifically outlined in Chapters 7, 8, and 15 of the Medicare Benefit Policy Manual.History of Section.P.L. 1966, ch. 266, § 2; P.L. 1968, ch. 189, § 2; G.L. 1956, § 40-10.1-4; Reorg. Plan No. 1, 1970; P.L. 1977, ch. 269, § 1; P.L. 1988, ch. 356, § 1; P.L. 1989, ch. 53, § 1; P.L. 1991, ch. 6, art. 13, § 1; P.L. 1993, ch. 138, art. 21, § 2; P.L. 2007, ch. 73, art. 17, § 1; P.L. 2007, ch. 230, § 1; P.L. 2011, ch. 151, art. 23, § 2; P.L. 2015, ch. 141, art. 5, § 9; P.L. 2021, ch. 162, art. 12, § 2, effective July 1, 2021.
RI Gen L § 40-8-4.1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-4.1 - Lowest price.

§ 40-8-4.1. Lowest price.(a) Notwithstanding any provision of law to the contrary, no medical assistance provider shall bill or charge the department of human services more than the provider's usual and customary charge, as defined within.(b) The term "usual and customary" means the lowest charge, fee, or rate charged by a provider for any product or service at the time the product or service was provided. For the purpose of determining the lowest charge, fee, or rate:(1) If the provider offers discounts or rebates, the amount after applying discounts or rebates shall be utilized;(2) If the provider offers a sale for a limited period of time on any good or service, the sale price shall be utilized during the sale period;(3) If the provider regularly accepts less than its full charge from any customer, that amount accepted shall be utilized;(4) If any good or service is offered free of charge by the provider, no charge shall be made to the department for the provision of the product or service to the department or a client of the department who satisfies the terms of the offer;(5) If any good or service is covered under any warranty or guarantee offered by the provider, the amount charged to the department shall not exceed the amount that would otherwise be payable solely by the customer; and(6) If a provider structures or packages its goods or services in a manner that is exclusively or primarily used for Medicaid, Medicare, or other third-party payors, the charge for the most similar good or service offered to any other consumer shall be utilized.(c) The following items shall not be utilized in determining the "usual and customary" or lowest charge, fee, or rate:(1) Discounts offered solely to bona fide employees or family members of employees;(2) Discounts offered solely on the basis of age shall be utilized in determining the usual and customary charge only when the client of the department satisfies the age requirement;(3) Free goods or services or discounts provided to a limited number of persons on the basis of financial hardship;(4) Charges by an organization on a sliding-fee scale for a good or service where the organization's charge is based on ability to pay;(5) Charges not collected as a result of bad debts incurred by the provider. A bad debt exists where sound business judgment indicates that there is no reasonable likelihood of recovery of the amount owed; and(6) Charges for educational-related services governed by 42 U.S.C. § 1396b(c).(d) The department may waive the application of this section if the department determines the action is necessary to ensure a continuum of care and service to persons served by community mental health centers, or to avert serious economic hardships to mental health centers.History of Section.P.L. 2009, ch. 68, art. 23, § 12.
RI Gen L § 40-8-5 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-5 - Agencies through which benefits paid.

§ 40-8-5. Agencies through which benefits paid.Benefits shall be applied for, and paid in accordance with, prescribed regulations through the state offices or state or private agencies or organizations as the director may designate, and as shall be approved by the federal government, or any department or agency thereof, making funds available in support of the medical care benefits provided for in this chapter or for administration purposes. The regulations shall meet the federal requirements as may be set forth as conditions precedent to receiving the federal funds.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-5; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-6 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-6 - Review of application for benefits.

§ 40-8-6. Review of application for benefits.The director, or someone designated by him or her, shall review each application for benefits filed in accordance with regulations, and shall make a determination of whether the application will be honored and the extent of the benefits to be made available to the applicant, and shall, within thirty (30) days after the filing, notify the applicant, in writing, of the determination. If the application is rejected, the notice to the applicant shall set forth therein the reason therefor. The director may at any time reconsider any determination.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-6; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-7 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-7 - Appeals - Hearing.

§ 40-8-7. Appeals — Hearing.Any applicant for or recipient of benefits aggrieved because of a decision, or delay in making a decision, shall be entitled to an appeal and shall be afforded reasonable notice and opportunity for a fair hearing conducted by the director.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-7; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-8 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-8 - Judicial review.

§ 40-8-8. Judicial review.Findings of fact by the director shall be final and his or her decision shall be subject to judicial review only by certiorari if the decision is arbitrary, capricious, or unreasonable or inconsistent with law.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-8; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-9 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-9 - Fraudulent receipt of assistance as larceny - Penalty.

§ 40-8-9. Fraudulent receipt of assistance as larceny — Penalty.Whoever knowingly makes a false statement or misrepresents a material fact with intent thereby to defraud the state of any benefit or wrongfully to obtain or increase any benefit either for himself or herself or for any other person shall, upon conviction, be punished by a fine of not less than twenty dollars ($20.00) nor more than fifty dollars ($50.00), or by imprisonment for not more than thirty (30) days, or by both a fine and imprisonment. Each false statement or representation shall constitute a separate and distinct offense.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-9; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-9.1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-9.1 - Notice.

§ 40-8-9.1. Notice.Whenever an individual who is receiving medical assistance under this chapter transfers an interest in real or personal property, the individual shall notify the executive office of health and human services within ten (10) days of the transfer. The notice shall be sent to the individual's local office and the legal office of the executive office of health and human services and include, at a minimum, the individual's name, social security number or, if different, the executive office of health and human services identification number, the date of transfer, and the dollar value, if any, paid or received by the individual who received benefits under this chapter. In the event an individual fails to provide notice required by this section to the executive office of health and human services and in the event an individual has received medical assistance, any individual and/or entity, who knew or should have known that the individual failed to provide the notice and who receives any distribution of value as a result of the transfer, shall be liable to the executive office of health and human services to the extent of the value of the transfer. Moreover, any such individual shall be subject to the provisions of § 40-6-15 and any remedy provided by applicable state and federal laws and rules and regulations. Failure to comply with the notice requirements set forth in the section shall not affect the marketability of title to real estate transferred while the transferor is receiving medical assistance.History of Section.P.L. 2012, ch. 241, art. 11, § 6.
RI Gen L § 40-8-10 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-10 - Recovery of benefits paid in error.

§ 40-8-10. Recovery of benefits paid in error.Any person, who through error or mistake of himself or herself or another, receives medical care benefits to which he or she is not entitled or with respect to which he or she was ineligible, shall be required to reimburse the state for the benefits paid through error or mistake.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-10; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 129.
RI Gen L § 40-8-11 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-11 - Civil action to recover benefits.

§ 40-8-11. Civil action to recover benefits.Any sums required to be reimbursed to the state under the provisions of § 40-8-10 and any benefits obtained by false statement or misrepresentation may be collected by civil action. All civil actions shall be instituted in the name of the director, and he or she shall be exempt from giving any surety for costs. In any action, the director may be represented by any qualified attorney whom he or she has designated and employed for this purpose, or, at the director's request, by the attorney general.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-11; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-12 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-12 - Federal approval.

§ 40-8-12. Federal approval.(a) The department is empowered and authorized to submit its plan for medical assistance to the federal government, or any agency or department thereof having funds available for medical care benefits provided for in this chapter, for approval pursuant to the provisions of the federal Social Security Act, 42 U.S.C. § 1396 et seq. The department shall act for the state in any negotiations relative to the submission and approval of the plan and may make any arrangement or changes in its plan not inconsistent with this chapter that may be required by the Social Security Act, or the rules and regulations promulgated pursuant thereto, to obtain and retain the approval and to secure for this state the benefits of the provisions of the federal act relating to medical assistance for the needy.(b) The department shall make reports to the federal government, or any agency or department thereof, in the form and nature required by it, and shall, in all respects, comply with any request or direction of the federal government, or any agency or department thereof, that may be necessary to assure the correctness and verification of the reports.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-12; Reorg. Plan No. 1, 1970; P.L. 2006, ch. 216, § 19.
RI Gen L § 40-8-13 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-13 - Rules, regulations, and fee schedules.

§ 40-8-13. Rules, regulations, and fee schedules.The director shall make and promulgate rules, regulations, and fee schedules not inconsistent with state law and fiscal procedures as he or she deems necessary for the proper administration of this chapter and to carry out the policy and purposes thereof, and to make the department's plan conform to the provisions of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and any rules or regulations promulgated pursuant thereto.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-13; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-13.1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-13.1 - [Repealed.]

§ 40-8-13.1. [Repealed.]History of Section.P.L. 1995, ch. 370, art. 32, § 1; P.L. 2000, ch. 55, art. 12, § 1; P.L. 2006, ch. 216, § 19; P.L. 2009, ch. 5, art. 15, § 1; Repealed by its own terms pursuant to P.L. 2009, ch. 68, art. 23, § 6, effective March 30, 2010.
RI Gen L § 40-8-13.2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-13.2 - [Repealed.]

§ 40-8-13.2. [Repealed.]History of Section.P.L. 2002, ch. 65, art. 33, § 1; P.L. 2007, ch. 73, art. 13, § 2; P.L. 2009, ch. 68, art. 23, § 6; Repealed by its own terms and pursuant to § 40-8-13.4(g), effective March 30, 2010.
RI Gen L § 40-8-13.3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-13.3 - Payment for services provided by in-state and out-of-state hospitals.

§ 40-8-13.3. Payment for services provided by in-state and out-of-state hospitals.The department of human services and/or the secretary of the executive office of health and human services is hereby authorized and directed to amend its rules and regulations and amend the Rhode Island state plan for medical assistance (Medicaid) pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., in order to provide for payment to hospitals for services provided to eligible recipients in accordance with this chapter. The amended rules and regulations will continue to recognize the importance, impact, and cost of the graduate medical education and training programs supported by the hospitals in Rhode Island. The provisions of this section shall be effective upon the promulgation of the amendments and new payment methodology pursuant to this section and § 40-8-13.4, on July 1, 2010, at which time the provisions of §§ 40-8-13.2, 27-19-14, 27-19-15 and 27-19-16 shall be repealed in their entirety.History of Section.P.L. 2009, ch. 68, art. 23, § 7; P.L. 2010, ch. 23, art. 20, § 1.
RI Gen L § 40-8-13.5 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-13.5 - Hospital Incentive Program (HIP).

§ 40-8-13.5. Hospital Incentive Program (HIP).The secretary of the executive office of health and human services is authorized to seek the federal authorities required to implement a hospital incentive program (HIP). The HIP shall provide the participating licensed hospitals the ability to obtain certain payments for achieving performance goals established by the secretary. HIP payments shall commence no earlier than July 1, 2016.History of Section.P.L. 2015, ch. 141, art. 5, § 10.
RI Gen L § 40-8-14 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-14 - Appropriations.

§ 40-8-14. Appropriations.The general assembly shall annually appropriate a sum as it may deem necessary to carry out the purposes of this chapter, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or sums or so much thereof as may be required from time to time, upon the receipt by him or her of properly authenticated vouchers.History of Section.P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-14; Reorg. Plan No. 1, 1970.
RI Gen L § 40-8-16 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-16 - Notification of long-term care alternative.

§ 40-8-16. Notification of long-term care alternative.(a) The department of human services, before authorizing care in a nursing home or intermediate-care facility for a person who is eligible to receive benefits pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and who is being discharged from a hospital to a nursing home, shall notify the person, in writing, of the provisions of the long-term-care alternative, a home- and a community-based program.(b) If a person, eligible to receive benefits pursuant to Title XIX of the federal Social Security Act, requires services in a nursing home and desires to remain in his or her own home or the home of a responsible relative or other adult, the person or his or her representative shall so inform the department.(c) The department shall not make payments pursuant to Title XIX of the federal Social Security Act for benefits until written notification documenting the person's choice as to a nursing home or home- and community-based services has been filed with the department.History of Section.P.L. 1987, ch. 500, § 1.
RI Gen L § 40-8-17 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-17 - Waiver request.

§ 40-8-17. Waiver request.(a) Formation. The executive office of health and human services is directed and authorized to apply for and obtain any necessary waiver(s), waiver amendment(s), and/or state plan amendments from the Secretary of the United States Department of Health and Human Services, including, but not limited to, an extension of the section 1115(a) demonstration waiver amended, as appropriate, and renamed to reflect the state's effort to coordinate all publicly financed health care. The secretary of the office shall ensure that the state's health and human services departments and the people and communities they serve in the Medicaid program shall have the opportunity to contribute to and collaborate in the formulation of any request for a new waiver, waiver extension, and/or state plan amendment(s). Any actions shall: (1) Continue efforts to rebalance the system of long-term services and supports by assisting people in obtaining care in the most appropriate and least restrictive setting; (2) Pursue further utilization of care-management models that promote preventive care, offer a health home, and provide an integrated system of services; (3) Use smart payments and purchasing to finance and support Medicaid initiatives that fill gaps in the integrated system of care; and (4) Recognize and ensure access to non-medical services and supports, such as peer navigation and employment and housing stabilization services, that are essential for optimizing a person's health, wellness, and safety and that reduce or delay the need for long-term services and supports.(b) Effective July 1, 2009, any provision presently in effect in the Rhode Island general laws where the executive office of health and human services is authorized to apply for and obtain any necessary waiver(s), waiver amendment(s), and/or state plan amendment(s) for the purpose of providing medical assistance to recipients, shall authorize the executive office of health and human services to proceed with appropriate category changes in accordance with the special terms and conditions of the Rhode Island Global Consumer Choice Compact section 1115(a) Demonstration Waiver or any extension thereof, as amended and/or renamed under the authority provided in this section.History of Section.P.L. 1987, ch. 500, § 2; P.L. 1988, ch. 84, § 26; P.L. 2008, ch. 100, art. 17, § 3; P.L. 2009, ch. 68, art. 23, § 11; P.L. 2013, ch. 144, art. 19, § 1.
RI Gen L § 40-8-19.2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-19.2 - Nursing Facility Incentive Program (NFIP).

§ 40-8-19.2. Nursing Facility Incentive Program (NFIP).The secretary of the executive office of health and human services is authorized to seek the federal authority required to implement a nursing facility incentive program (NFIP). The NFIP shall provide the participating licensed nursing facilities the ability to obtain certain payments for achieving performance goals established by the secretary. NFIP payments shall commence no earlier than July 1, 2016.History of Section.P.L. 2015, ch. 141, art. 5, § 11.
RI Gen L § 40-8-20 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8 - Medical Assistance|Section 40-8-20 - [Repealed.]

§ 40-8-20. [Repealed.]History of Section.P.L. 1993, ch. 138, art. 20, § 1; Repealed by P.L. 2003, ch. 376, art. 41, § 2, effective October 1, 2005.