§ 27-34.2-18 — § 27-34.2-18. Pre-certification for Medicaid protection of resources.

Rhode Island § 27-34.2-18

• Jurisdiction: Rhode Island
• Title 27: Insurance
• Ch. 27-34.2: Long-Term Care Insurance

Text

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

The department of business regulation shall pre-certify long-term care insurance policies that meet all other applicable requirements imposed by this chapter and that:

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

(2) In all home care plans, include case management services which services shall include, but need not be limited to, the development of a comprehensive individualized assessment and care plan and, as needed, the coordination of appropriate services and the monitoring of the delivery of those services;

(3) Provide inflation protection;

(4) Provide for the keeping of records and an explanation of benefit reports on insurance payments that count toward Medicaid resource exclusion; and

(5) Provide the management information and reports necessary to document the extent of Medicaid resources protection offered and to evaluate the Rhode Island partnership for long-term care. No policy shall be precertified if it requires prior hospitalization or a prior stay in a nursing home as a condition of providing benefits. The department of business regulation may adopt regulations to carry out the precertification provisions of this section.

Legislative History

P.L. 1993, ch. 454, § 2; G.L. 1956, § 27-34.2-19.