Section 210-RICR-50-05-1.4 - Accessing Medicaid in Health InstitutionsA. Medicaid LTSS is available to applicants and beneficiaries who meet the non-financial, financial and functional/clinical eligibility criteria for eligibility set forth in Subchapter 00 Part 5 of this Chapter. 1. Continuous need for LTSS - A person must have an established need for continuous LTSS as set forth in Subchapter 00 Part 1 of this Chapter to qualify for LTSS in a health institution.2. Highest need for LTSS -- As indicated in the provisions on functional/clinical eligibility in Subchapter 00 Part 5 of this Chapter, access to LTSS in health institutions is tied to the level of need. Under the terms of the State's Section 1115 demonstration, an applicant or beneficiary must have the highest need for an institutional level of care to access care in a nursing facility, ICF/I-DD or long-term hospital.B. Federal and state laws prohibit licensed health institutions from discriminating against a person solely because of health care payer. Accordingly, a health institution is not permitted to deny admission for LTSS on this basis to an otherwise qualified Medicaid beneficiary. Health institutions must adhere to the applicable notice and due process requirements specified herein prior to discharging a person based on the loss of Medicaid eligibility.C. Medicaid LTSS in health institutions is a Medicaid State Plan covered benefit. Accordingly, Medicaid beneficiaries residing in health institutions have access to the full array of covered primary care essential benefits and long-term services and supports. The scope of Medicaid covered services each type of health institution provides differs, depending on licensure status and the needs of the populations they serve. The State must assure a beneficiary has access to a needed covered service in situations in which the health institution where he or she resides does not have the capacity or authority to provide that service.210 R.I. Code R. 210-RICR-50-05-1.4