§ 27-34.2-18 - Pre-certification for Medicaid protection of resources. - Rhode Island Statutes

SECTION 27-34.2-18

   § 27-34.2-18  Pre-certification forMedicaid protection of resources. – The department of business regulation shall pre-certify long term careinsurance policies which meet all other applicable requirements imposed by thischapter and which:

   (1) Offer the option of home and community based services inaddition to nursing home care;

   (2) In all home care plans, include case management serviceswhich services shall include, but need not be limited to, the development of acomprehensive individualized assessment and care plan and, as needed, thecoordination of appropriate services and the monitoring of the delivery ofthose services;

   (3) Provide inflation protection;

   (4) Provide for the keeping of records and an explanation ofbenefit reports on insurance payments which count toward Medicaid resourceexclusion; and

   (5) Provide the management information and reports necessaryto document the extent of Medicaid resources protection offered and to evaluatethe Rhode Island partnership for long term care. No policy shall beprecertified if it requires prior hospitalization or a prior stay in a nursinghome as a condition of providing benefits. The department of businessregulation may adopt regulations to carry out the precertification provisionsof this section.