(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.

Terms Used In Rhode Island General Laws 40-8.8-7

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • person: may be construed to extend to and include co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6
  • Program of all-inclusive care for the elderly: shall mean a program of services coordinated for the eligible population by an organization approved by the United States Department of Health and Human Services for these purposes. See Rhode Island General Laws 40-8.8-4

(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.

History of Section.
P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1; P.L. 2022, ch. 435, § 1, effective June 30, 2022; P.L. 2022, ch. 436, § 1, effective June 30, 2022.