Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 40 - Medicaid for Elders and Adults with Disabilities › Subchapter 00 - Integrated Coverage Groups › Part 2 - Application and Renewal Process for IHCC Groups › Section 210-RICR-40-00-2.5 - Beneficiary Responsibilities

Current through June 14, 2024
A. Medicaid
				  beneficiaries must provide accurate and complete information about any
				  eligibility factors subject to change at the time of the application and annual
				  renewal. Accordingly:
1. Consent - At the
				  time of the initial application or first renewal, Medicaid beneficiaries are
				  required to provide the State with consent to retrieve and review any
				  information not currently on record pertaining to the eligibility factors
				  subject to change through electronic data matches conducted through the State's
				  eligibility system. Once such consent is provided, the Medicaid agency may
				  retrieve and review such information when conducting all subsequent annual
				  renewals.
2. Duty to Report -
				  Medicaid beneficiaries are required to report changes in eligibility factors to
				  the Medicaid agency within ten (10) days from the date the change takes effect.
				  Self- reports are permitted through the eligibility system consumer
				  self-service portal as well as in person, via fax, or mail. Failure to report
				  in a timely manner may result in the discontinuation of Medicaid
				  eligibility.
3. Cooperation -
				  Medicaid members must provide any documentation that otherwise cannot be
				  obtained related to any eligibility factors subject to change when requested by
				  the Medicaid agency. The information must be provided within the timeframe
				  specified by the Medicaid agency in the notice to the Medicaid member stating
				  the basis for making the agency's request.
4. Voluntary Termination - A Medicaid
				  beneficiary may request to be disenrolled from a Medicaid health plan or to
				  terminate Medicaid eligibility at any time. Such requests must be made in
				  writing and preferably two (2) weeks prior to the date of disrenrollment or the
				  date a beneficiary seeks to end eligibility.
5. Reliable Information - Medicaid applicants
				  and beneficiaries must sign under the penalty of perjury that all information
				  provided at the time of application and any annual renewals thereafter is
				  accurate and truthful.
6. Change of
				  Service Delivery Options - Medicaid beneficiaries may change Medicaid health
				  plans during the annual open enrollment period. Notice of the open enrollment
				  period is provided to beneficiaries at least thirty (30) days prior to the date
				  the period begins. Beneficiaries may also request to change service delivery
				  options at any other time in accordance with the procedures set forth in
				  Subchapter 10 Part 1 of this Chapter, or if MACC group eligible, Medicaid Code
				  of Administrative Rules, RIte Care Program, Rhody Health Program, Enrollment,
				  and RIte Share Program.
7.
				  Alternative forms of Benefits/Assistance - Applicants and beneficiaries must,
				  as a condition of eligibility, take any necessary steps to obtain annuities,
				  pensions, retirement and disability benefits along with any other forms of
				  assistance available for support and maintenance that may be identified by the
				  agency, in writing, in accordance with Medicaid Code of Administrative Rules
				  Cooperation Requirements. Good cause exceptions are considered when requested
				  in writing.