210 R.I. Code R. 210-RICR-20-00-1.6

Current through December 3, 2024

Section 210-RICR-20-00-1.6 - Provider Eligibility - Screening Requirements

A. EOHHS performs a screening of all providers to ensure that providers meet all State and federal requirements for enrollment and/or continued participation as a provider in the Medicaid program. The screening process corresponds to the provider's classification as a limited-risk provider, moderate-risk provider, or high-risk provider, as determined by EOHHS. If a provider could fit within more than one (1) risk level, the highest level of screening shall be applicable. The information gathered during this screening shall impact eligibility for participation as a Medicaid provider, as described herein.

B. EOHHS performs the minimum screenings required by State and federal law and regulations for each risk level. For moderate-risk and high-risk providers, federal law requires an unannounced site visit.

C. For the following providers, and if a provider entity all persons with a five percent (5%) or greater direct or indirect ownership interest in such providers, state and federal law require a national criminal records check supported by fingerprints, conducted through the Office of Attorney General:

1. Providers designated by the Centers for Medicare and Medicaid Services (CMS) as high categorical risk;

2. Individual personal care attendants and homemakers providing direct care to individuals under Chapter 50-10-2 of this Title; and

3. Shared living caregivers providing direct care to individuals under Chapter 50-10-1 of this Title.

D. Upon determining that a provider or applicant to become a provider requires a national background check supported by fingerprints, EOHHS shall make a written request to submit fingerprints. The individual shall submit a set of fingerprints within thirty (30) days upon written request from EOHHS. The individual is responsible for the cost of the fingerprint.

E. Fingerprints shall be valid for a five (5) year period.

210 R.I. Code R. 210-RICR-20-00-1.6

Amended effective 3/17/2022
Amended effective 7/17/2023
Amended effective 3/17/2024