Title 40, Title 40 Services

The attorney general may petition the court to enter a consent decree dismissing any criminal prosecution hereunder, but the court shall review the proceeding to determine whether entry thereof is in the public interest.

(a) Demand. (1) The attorney general, or his or her designated assistant attorney general, shall have the power to issue a subpoena or subpoena duces tecum. (2) Whenever the attorney general has reasonable cause to believe that any person may have knowledge or be in possession, c…

No investigative demand pursuant to this chapter shall solicit, extend to, or compel the production, inspection, copying, or release of any record or information otherwise protected as confidential healthcare information pursuant to chapter 37.3 of title 5.

No provider shall charge the Rhode Island Medicaid program for any services rendered to recipients subsequent to the revocation or suspension of the provider’s certification except as specified by a termination notice.

An order of the executive office of health and human services revoking a provider’s certification may, in the discretion of the program, go into immediate effect or may be stayed. Review of any order may be had in accordance with the Rhode Island administrative procedures act, §§…

An administrative decision, not appealed, or which has been affirmed after judicial review under the Rhode Island administrative procedures act, §§ 42-35-1 — 42-35-18, determining any amounts due to the executive office of health and human services or to a provider, may be filed …

Before any provider of medical services receives payment from the Rhode Island Medicaid program, and as a condition of receipt of payment, the provider must have in effect a valid certification of eligibility from the Rhode Island executive office of health and human services. Th…

Whenever used in this chapter: (1) “Benefit” means pecuniary benefit as defined herein. (2) “Claim” means any request for payment, electronic or otherwise, and shall also include any data commonly known as encounter data, that is used, or is to be used, for the development of a c…

A certification will apply to any provider who agrees to provide services in accordance with the laws and regulations governing the Rhode Island Medicaid program and who has in effect a proper professional license when a license is a prerequisite to rendering services. Nothing co…

(a) The executive office of health and human services may issue a suspension of payments order if: (1) The provider does not meet certification requirements of the Rhode Island Medicaid program; or (2) The Rhode Island Medicaid program has been unable to collect (or make satisfac…

Any provider of services or goods contracting with the executive office of health and human services, pursuant to Title XIX or Title XXI of the Social Security Act, who, without intent to defraud, obtains payments under this chapter in excess of the amount to which the provider i…

Medicaid reimbursement for costs incurred directly related to influencing employees regarding their right to organize, to form a union, or to join a union, shall not be considered to be allowable, whether performed directly by the provider or through contracts with consultants or…

(a) It shall be unlawful for any person intentionally to: (1) Present, or cause to be presented, for preauthorization or payment to the Rhode Island Medicaid program: (i) Any materially false or fraudulent claim or cost report for the furnishing of services or merchandise; or (ii…

The statute of limitations for any violation of the provisions of this chapter shall be ten (10) years.

Any person, including the secretary of the executive office of health and human services or the office of program integrity acting on behalf of the secretary of the office, injured by any violation of the provisions of § 40-8.2-3 or § 40-8.2-4 may recover through a civil action f…

(a) The attorney general may bring a civil action in superior court in the name of the state, as parens patriae on behalf of persons residing in this state, to secure monetary relief as provided in this section for injuries sustained by such persons by reason of any violation of …

Whoever knowingly and willfully makes, or causes to be made, or induces, or seeks to induce, the making of any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that the institution or facility…

(a) A corporation, association, firm, partnership, or limited partnership is liable for the acts of its officers, directors, representatives, or agents acting within the scope of their authority. Proof of the acts of any officer, director, representative, or agent shall be receiv…

When the cost of the services provided to the patient is being paid under the Rhode Island Medicaid program, any person who knowingly and willfully: (1) Charges a patient, or anyone acting on behalf of a patient, money or other consideration at a rate in excess of the rates estab…