Page 3

multi-tiered evaluation of eligibility that makes it possible to consider applicants for most forms of publicly financed health coverage and various other State-administered health and human services through a single application process. 1.4 Definitions A. For the purposes of this Chapter, the following definitions apply: 1. “Affordable Care Act” or “ACA” means the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, and the Three Percent Withholding Repeal and Job Creation Act, Pub. L. No. 112- 56. 2. “Applicant” means the person in the household who, if determined eligible, would qualify for Medicaid in one of the Integrated Health Care Coverage groups on the basis of the provisions set forth herein. 3. “Calendar quarter” means a period of three (3) full calendar months beginning with January, April, July, or October. 4. “Community Medicaid” means the term used to refer to IHCC groups that are provided with Medicaid health coverage for essential primary care and limited preventive services in some circumstances, but does not include more than thirty (30) days of continuous LTSS. 5. “Executive Office of Health and Human Services” or “EOHHS” means the state agency established under the provisions of R.I. Gen. Laws Chapter 42-7.2 designated as the single State agency for the Medicaid program. 6. “Dual Eligible Beneficiary” means a person who is enrolled in Medicaid and Medicare. The term includes elders and adults with disabilities who are enrolled in Medicare and receive Medicaid health coverage and/or financial assistance through the State’s Medicare Premium Payment Program (MPPP). 7. “Income Standard” or “Income Limit” means the maximum amount of countable income a person can have to qualify for Medicaid health coverage through an eligibility pathway or coverage group after all required exclusions, disregards, and deductions. 8. “Long-Term Services and Supports” or “LTSS" means a spectrum of services covered by the Rhode Island Medicaid program for persons with clinical and functional impairments and/or chronic illness that require the level of care typically provided in a health care institution. Medicaid LTSS includes skilled or custodial nursing facility care, therapeutic day services, and personal care as well as various home and community-based