Page 1

210-RICR-30-00-5 TITLE 210 – EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES CHAPTER 30 – MEDICAID FOR CHILDREN, FAMILIES AND AFFORDABLE CARE ACT (ACA) ADULTS SUBCHAPTER 00 – AFFORDABLE COVERAGE GROUPS PART 5 – MEDICAID MAGI FINANCIAL ELIGIBILITY DETERMINATIONS AND VERIFICATION 5.1 Scope and Legal Authority A. The purpose of this rule is to describe the Modified Adjust Gross Income (MAGI) standard and explain how it is applied; and establish the role and responsibilities of the State and consumers when determining MAGI-related eligibility for the Medicaid Affordable Care Coverage (MACC) groups identified in Part 1 of this Subchapter. B. This Part is promulgated pursuant to: 1. Federal authorities as follows: a. Federal Laws: § 1115 of the Social Security Act, 42 U.S.C. § 1315; Title IV of the Social Security Act, 42 U.S.C. §§ 601-687; Title XIX of the Social Security Act, 42 U.S.C. §§ 1396a-1396w-8; Title XXI of the Social Security Act, §§ 42 U.S.C. 1397aa 1397mm; § 1413(b)(1)(A) of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148; § 1004 of the Health Care and Education Reconciliation Act of 2010, Pub. Law 111-115; Title I § 11051(c) of the Tax Cuts and Jobs Act of 2017, Pub. Law 115-197, § 5112 of the Consolidated Appropriations Act, Pub. Law 117-328. b. Federal Regulations – 42 C.F.R. §§ 435.603; 435.902-910; 435.916; and 435.1005 c. The Medicaid State Plan and the Section 1115 Demonstration Waiver. granted pursuant to § 1115 of the Social Security Act, 42 U.S.C § 1315 2. State authorities – R.I. Gen. Laws Chapters 40-6, 40-8, and 42-7.2.