Rhode Island Code of Regulations › Title 218 - Department of Human Services › Chapter 10 - General Provisions › Subchapter 00 - N/A › Part 1 - General Provisions › Section 218-RICR-10-00-1.2 - Definitions

Current through June 14, 2024
"Affordable Care Coverage" or "ACC" means affordable
					 Medicaid coverage for low-income individuals who are otherwise ineligible for
					 Medicaid and not eligible for or enrolled in Medicare.
"Agency" means the Department of Human Services (DHS),
					 including any board, commission or officer of the department.
"Agency error" means that an individual or household
					 unintentionally received increased or decreased benefits caused by incorrect
					 actions (including delayed or no action) by the Department of Human Services
					 staff or department processes.
"Child Care Assistance Program" or "CCAP" means a state
					 agency program for low-income working families to access affordable,
					 high-quality early care and afterschool programs.
"Department of Behavioral Healthcare, Development
					 Disabilities and Hospitals" or "BHDDH" means the state agency that is
					 responsible for planning, funding and overseeing a community system of services
					 and supports for adults with behavioral health disabilities and/or
					 developmental disabilities.
"Department of Children, Youth and Families" or "DCYF"
					 means the state agency which is responsible for the safety, protection and
					 well-being of children through a family and child-centered wrap-around model of
					 care. DCYF partners with families and communities to raise safe and healthy
					 children and youth in a caring environment.
"Department of Human Services" or "DHS" means the state
					 agency that provides a full continuum of services for families, adults,
					 children, elders, individuals with disabilities and veterans.
"Division of Elderly Affairs" or "DEA" means the state
					 agency that provides care and support for the state's elderly population and
					 their families.
"Elders and Adults with Disabilities" "EAD" means the
					 Medicaid IHCC group established by R.I. Gen. Laws Chapter 40-8.5 for adults
					 with a SSI characteristic related to age (elders 65 years of age or older) or
					 disability.
"Executive Office of Health and Human Services" or "EOHHS"
					 means the state agency that is designated under the Medicaid State Plan as the
					 Single State Agency responsible for the administration of the Title XIX
					 Medicaid Program.
"Department of Health" or "DOH" means the state agency that
					 addresses the social and environmental determinants of health, eliminates the
					 disparities of health and promotes health equity. It also ensures access to
					 quality health services for the citizens of Rhode Island.
"Federal data hub" means the database of the United States
					 population built by the U.S. Internal Revenue Service (IRS) and Health and
					 Human Services (HHS) used to facilitate determinations for coverage, including
					 Medicaid, under the Affordable Care Act of 2010 (42 U.S.C. §
											18001  et seq.).
"Fraud" means an applicant or recipient who knowingly
					 provides false information or fails to disclose pertinent information affecting
					 eligibility of benefits to the Department of Human Services (DHS) for purposes
					 of procuring payment or services under any assistance program administered by
					 the DHS.
"Fraud unit" means the Fraud Detection and Prevention Unit,
					 Office of Internal Audits, and/or the Department of Administration.
"General Public Assistance Program" or "GPA" means a state
					 program for adults age eighteen (18) and over who have very limited income and
					 resources and have an illness or medical condition that keeps them from
					 working. This program also applies to adults who apply for Supplemental
					 Security Income (SSI) but are not yet determined eligible, and may receive GPA
					 benefits while their disability determination review occurs.
"General Public Assistance - Hardship Program" means a type
					 of cash assistance state program that must be requested by an individual who is
					 pending SSI and GPA Bridge program. This program consists of a bi-monthly
					 payment to the recipient which is reviewed on a monthly basis.
"HealthSource RI" or "HSRI" means the state-based health
					 insurance marketplace (also referred to as a benefit exchange) established in
					 conjunction with implementation of the federal Affordable Care Act (42 U.S.C. §
											18001  et seq.).
"Household error" means an error or unintentional omission
					 in the information submitted by the household that may have affected program
					 benefits.
"Integrated Health Care Coverage Group" or "IHCC" means any
					 Medicaid coverage group consisting of adults who are eligible upon receipt of
					 Supplemental Security Income (SSI), SSI protected status, the SSI income
					 methodology and a related characteristic (age or disability), or a result of
					 participation in another federal or state program.
"Intentional program violations" means an individual or
					 household that committed any act that constitutes a violation of the
					 Supplemental Nutrition Assistance Program (SNAP), SNAP regulations, or any
					 State statute for the purpose of using, presenting, transferring, acquiring,
					 receiving, possessing or trafficking of SNAP benefits or EBT cards. This may
					 also consist of having intentionally made a false or misleading statement, or
					 misrepresented, concealed or withheld facts from the Department of Human
					 Services.
"Katie Beckett" or "KB" means a Medicaid program to provide
					 health insurance coverage to children under age 19 who are living at home but
					 have complex health needs that typically require the care provided in a health
					 facility.
"Long Term Social Services" or "LTSS" means program
					 services to individuals that may need long term care. The Department of Human
					 Services provides publicly funded long-term services and supports to meet the
					 needs of individuals with chronic illnesses or disabilities.
"Medical Assistance Program" also known as "Medicaid" or
					 "MA" means a federal and state funded program that pays for medical and health
					 related services for eligible applicants/recipients.
"Medicare Premium Payment Program" or "MPPP" means the
					 program that assists individuals over age 65 and individuals with disabilities
					 pay all or some of the costs of Medicare Part A and Part B premiums,
					 deductibles and co-payments.
"Office of Child Support Services" or "OCSS" means the
					 state agency that provides services such as; establishing paternity of
					 children, establishing court orders for financial and medical support,
					 modifies, changes and enforces support orders.
"Office of Rehabilitation Services" or "ORS" means the
					 state agency that provides a wide variety of services to individuals with
					 disabilities.
"Office of Veterans Affairs" or "VA" means the state agency
					 that provides social services and information of all programs and benefits to
					 veterans and their dependents. It is also responsible for the administration of
					 the Veteran's Home, the Rhode Island Veteran's Cemetery, grave registration
					 program and the Historical Cemeteries Program.
"Overpayment" means the program benefits were received in
					 excess of the eligible benefit amount.
"Provider error" means that an institution unintentionally
					 received increased benefits caused by incorrect actions (including delayed or
					 no action) by the Department of Human Services staff or department
					 processes.
"RI Bridges" means Rhode Island's health and human services
					 eligibility and enrollment system. It is also known as the Unified Health
					 Infrastructure Project (UHIP).
"Rhode Island Works Program" or "RIW" means the agency
					 program offers temporary cash assistance, child care assistance and assistance
					 in finding employment or job training to needy families.
"Social Services" or "SS" means the federal and state
					 program authorized under Title XX of the Social Security Act (42 U.S.C. 1397) to meet the social service needs of
					 individuals and families who are receiving RIW or SSI and other individuals and
					 families whose income is less than the established standard.
"Supplemental Nutrition Assistance Program" or "SNAP" means
					 the state-administered federal program that helps individuals and families buy
					 food.
"Supplemental Security Income" or "SSI" means a Federal
					 income program designed to help aged, blind and disabled individuals who have
					 little or no income and few resources. The program provides cash to meet basic
					 needs for food, clothing and shelter.
"State Supplemental Payment Program" or "SSP" means a state
					 program that augments SSI in the form of cash assistance.