§ 27-18.4-1 - Definitions. - Rhode Island Statutes

SECTION 27-18.4-1

   § 27-18.4-1  Definitions. – (a) "Insurer" means any health insurer (including a group health plan, asdefined in § 607(1) of the Employee Retirement Income Security Act of1974, 29 U.S.C. § 1167(1)), a health maintenance organization as definedin § 27-41-2, a qualified health maintenance organization as referred toin § 42-62-9, a non-profit hospital service corporation as defined in§ 27-19-1, a non-profit medical service corporation as defined in §27-20-1, a non-profit dental service corporation as defined in §27-20.1-1, a non-profit optometric service corporation as defined in §27-20.2-1, self insured plans, pharmacy benefit managers (PBM), and otherparties that are by statute, contract, or agreement, legally responsible forpayment of a claim for a health care item of service doing business in thestate, a domestic insurance company subject to chapter 1 of this title, and aforeign insurance company subject to chapter 2 of this title.

   (b) "Medical assistance" and "Medicaid" mean medicalassistance provided in whole or in part by the department of human servicespursuant to chapter 5.1, 8, 8.4 of title 40 or 12.3 of title 42 and/or titleXIX or XXI of the federal Social Security Act, as amended, 42 U.S.C. §1396 et seq. and 42 U.S.C. § 1397aa et seq., respectively.