2009 Rhode Island Code
Title 40 - Human services
CHAPTER 40-8 - Medical Assistance
§ 40-8-13.1 - Reimbursement for out-of-state hospital services.

SECTION 40-8-13.1

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

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

   (c) The department may periodically adjust the inpatient and/or outpatient service reimbursement rate(s) based upon a medical care cost index 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 on or after March 1, 2009 at rates determined by the department and in accordance with federal regulations.

   (e) The provisions of this section shall be repealed upon the promulgation of amendments and new methodology pursuant to §§ 40-8-13.3 and 40-8-13.4, but in any event no later than March 30, 2010.