§ 27-34.2-18. Pre-certification for Medicaid protection of resources.
The department of business regulation shall pre-certify long term care insurance policies which meet all other applicable requirements imposed by this chapter and which:
(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 which 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.
(P.L. 1993, ch. 454, § 2; G.L. 1956, § 27-34.2-19.)