Section 210-RICR-30-05-3.2 - Scope and PurposeA. This Part applies to individuals and families determined to be Medicaid eligible under RICR Title 210, Chapter 30 (Medicaid for Children, Families, and Affordable Care Act (ACA) Adults). If these individuals or families have access to ESI, EOHHS must conduct a review of the coverage to determine if the benefits are comparable to Medicaid benefits and if the cost of the ESI is less expensive than Medicaid managed care (in the aggregate). When ESI is found to be cost-effective, the State will pay the employee's premium for that coverage.B. The purpose of this rule is to set forth the provisions governing participation in the RIte Share Program, the buy-in requirement and the process for determining whether an ESI plan meets the cost-effectiveness criteria established by EOHHS, the Medicaid agency. The rule also identifies the respective roles and responsibilities of Medicaid-eligible individuals and families and the Medicaid agency.210 R.I. Code R. 210-RICR-30-05-3.2
Amended effective 8/6/2019