Rhode Island § 40-8-27 - Medical Assistance

§ 40-8-27. Cooperation by providers.

Medicaid providers who employ individuals applying for benefits under any chapter of this title shall comply in a timely manner with requests made by the department for any documents describing employer-sponsored health insurance coverage or benefits the provider offers that are necessary to determine eligibility for the state’s premium assistance program pursuant to § 40-8.4-12. Documents requested by the department may include, but are not limited to, certificates of coverage or a summary of benefits and employee obligations. Upon receiving notification that the department has determined that the employee is eligible for premium assistance under § 40-8.4-12, the provider shall accept the enrollment of the employee and his or her family in the employer-based health insurance plan without regard to any seasonal enrollment restrictions, including open-enrollment restrictions, and/or the impact on the employee’s wages. Additionally, the Medicaid provider employing such persons shall not offer “pay in lieu of benefits.” Providers who do not comply with the provisions set forth in this section shall be subject to suspension as a participating Medicaid provider.