Section 210-RICR-20-00-1.1 - Legal AuthorityA. The Rhode Island Medicaid Program provides health care coverage authorized by Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396w-7 (Federal Medicaid Law) and Title XXI of the Social Security Act, 42 U.S.C. §§ 1397aa-1397mm (Federal Children's Health Insurance Program ("CHIP") law) as well as the State's Medicaid State Plan and Section 1115 demonstration waiver granted under the authority of §1115 of the Social Security Act, 42 U.S.C. § 1315. To participate in the Medicaid program, health care providers must be certified and agree to abide by the requirements established in federal law, Rhode Island General Laws, and State and Federal Rules and Regulations.B. To qualify for Federal matching funds, payments to certified providers for authorized services must be made in accordance with methodologies established by the State and approved for such purposes by the Secretary of the U.S. Department of Health and Human Services (DHHS) and/or the Federal Centers for Medicare and Medicaid Services (CMS). The Secretary of the EOHHS is authorized to set forth in Rule, contractual agreements, provider certification standards, and/or payment methodologies the requirements for obtaining Federal financial participation established in Federal laws, Regulations, or other such authorities. This Rule governs participation of and payments to health care providers participating in the Medicaid program.210 R.I. Code R. 210-RICR-20-00-1.1
Amended effective 3/17/2022
Amended effective 7/17/2023
Amended effective 3/17/2024