§ 40-8-13.1 - Reimbursement for out-of-state hospital services. - Rhode Island Statutes

SECTION 40-8-13.1

   § 40-8-13.1  Reimbursement for out-of-statehospital services. – (a) The department of human services is hereby authorized and directed toamend, effective July 1, 1995, its regulations, fee schedules and the RhodeIsland state plan for medical assistance (Medicaid) pursuant to Title XIX ofthe federal Social Security Act to provide for reimbursement to out-of-statehospitals for services provided to eligible recipients in accordance with thissection.

   (b) Authorized inpatient hospital services shall bereimbursed at a rate equal to fifty percent (50%) of the out-of-statehospital's customary charge(s) for such services to Title XIX recipients inthat state; provided, however, that in-patient hospital organ transplantservices shall be reimbursed at sixty-one percent (61%) of the out-of-statehospital's customary charge(s) for such organ transplant services to Title XIXrecipients in that state. Authorized outpatient hospital services (other thanlaboratory services) shall be reimbursed at a rate equal to fifty-three percent(53%) of the out-of-state hospital's customary charge(s) for such services toTitle XIX recipients in that state; outpatient laboratory services shall bereimbursed at the Medicare allowable rate.

   (c) The department may periodically adjust the inpatientand/or outpatient service reimbursement rate(s) based upon a medical care costindex to be determined by the department.

   (d) Notwithstanding any provision of the law to the contrary,the department will reimburse out-of-state hospitals for services incurred onor after March 1, 2009 at rates determined by the department and in accordancewith federal regulations.

   (e) The provisions of this section shall be repealed upon thepromulgation of amendments and new methodology pursuant to §§40-8-13.3 and 40-8-13.4, but in any event no later than March 30, 2010.