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Suspension of payments to a provider - R.I. Gen. Laws Ann. § 27-8.2-21

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The Rhode Island Medicaid program may suspend provider payments if: (1) the provider fails to meet program certification requirements; (2) the provider fails to return overpayments to the program; (3) The program and/or Medicaid fraud control unit is unable to obtain information from the provider that is necessary to determine overpayment amounts; (4) The Medicaid fraud control unit cannot reasonably access information from the provider regarding current or former long-term care residents; (5) the program and/or Medicaid fraud control unit is denied access to information necessary to conduct 42 U.S.C. § 1396b(g) activities; or (6) the program has reliable evidence that the provider is engaged in Medicaid fraud. The program must resume payments upon determining that the provider has remedied the issue that resulted in the suspension.


Current as of June 2015