Rhode Island General Laws > Chapter 5-10 – Barbers, Hairdressers, Cosmeticians, Manicurists and Estheticians


§ 5-10-1	Definitions
§ 5-10-2	Creation of division of professional regulation and board of barbering and hairdressing – Powers and duties
§ 5-10-3	Board of barbering and hairdressing – Appointments – Organization – Removal of members
§ 5-10-4	Board of barbering and hairdressing – Compensation of members
§ 5-10-6	Meetings of board – Time and notice of examinations
§ 5-10-7	License required for practice
§ 5-10-8	Issuance of licenses – Qualifications of applicants
§ 5-10-9	Classes of licenses
§ 5-10-9.1	License portability
§ 5-10-10	Application form – Fee – Expiration and renewal of licenses – Fees
§ 5-10-11	Persons licensed in other states
§ 5-10-15	Licensing of shops
§ 5-10-19	Application forms
§ 5-10-20	Electrolysis not permitted by license
§ 5-10-21	Advertising
§ 5-10-23	Fixed place of business
§ 5-10-25	Inspection powers of the division – Denial of access
§ 5-10-26	Revocation or suspension of license, permit, or certificate
§ 5-10-27	Reinstatement after revocation or suspension
§ 5-10-28	Appeals
§ 5-10-29	Persons exempt from chapter
§ 5-10-30	Penalty for violations
§ 5-10-31	Prosecution of violations
§ 5-10-32	Enforcement of chapter
§ 5-10-33	Payment of fees
§ 5-10-35	Severability
§ 5-10-36	Receipts
§ 5-10-39	Demonstrator’s permit

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Terms Used In Rhode Island General Laws > Chapter 5-10 - Barbers, Hairdressers, Cosmeticians, Manicurists and Estheticians

Adverse benefit determination: means a decision not to authorize a healthcare service, including a denial, reduction, or termination of, or a failure to provide or make a payment, in whole or in part, for a benefit. See Rhode Island General Laws 27-18.8-2
Adverse benefit determination: means a decision not to authorize a healthcare service, including a denial, reduction, or termination of, or a failure to provide or make a payment, in whole or in part, for a benefit. See Rhode Island General Laws 27-18.9-2
Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
Affiliation period: means a period which, under the terms of the health insurance coverage offered by a health maintenance organization, must expire before the health insurance coverage becomes effective. See Rhode Island General Laws 27-18.6-2
Affordable Care Act: means the federal Patient Protection and Affordable Care Act of 2010, as amended by the federal Health Care and Education Reconciliation Act of 2010, and federal regulations adopted thereunder. See Rhode Island General Laws 27-18-1.1
Affordable Care Act: means the federal Patient Protection and Affordable Care Act, Pub. See Rhode Island General Laws 27-19-1
Affordable Care Act: means the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010, and federal regulations adopted thereunder. See Rhode Island General Laws 27-20-1
Aftermarket part: means a motor vehicle replacement part that is not an original equipment manufacturer part; and

(2) "Original equipment manufacturer part" or "OEM part" means a motor vehicle replacement part manufactured by the manufacturer of the motor vehicle being repaired. See Rhode Island General Laws 27-10.2-1
Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
Applicant: means a commercial run-off insurer applying under Rhode Island General Laws 27-14.5-1
Appraisal: A determination of property value.
Apprentice barber: means an employee whose principal occupation is service with a barber who has held a current license as a barber for at least three (3) years with a view to learning the art of barbering, as defined in subsection (14). See Rhode Island General Laws 5-10-1
Assessment deficit: means the amount that the assessment for the previous year under Rhode Island General Laws 27-14.5-1
Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
Assumption policyholder: means a policyholder whose policy is reinsured under an assumption reinsurance agreement between the applicant and a reinsurer. See Rhode Island General Laws 27-14.5-1
Assumption reinsurance agreement: has the meaning given in Rhode Island General Laws 27-14.5-1
Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
Authorization: means a review by a review agent, performed according to this chapter, concluding that the allocation of healthcare services ordered by a provider, given or proposed to be given to a beneficiary, was approved or authorized. See Rhode Island General Laws 27-18.9-2
Authorized representative: means an individual acting on behalf of the beneficiary and shall include: the ordering provider; any individual to whom the beneficiary has given express written consent to act on his or her behalf; a person authorized by law to provide substituted consent for the beneficiary; and, when the beneficiary is unable to provide consent, a family member of the beneficiary. See Rhode Island General Laws 27-18.8-2
Authorized representative: means an individual acting on behalf of the beneficiary and shall include: the ordering provider; any individual to whom the beneficiary has given express written consent to act on his or her behalf; a person authorized by law to provide substituted consent for the beneficiary; and, when the beneficiary is unable to provide consent, a family member of the beneficiary. See Rhode Island General Laws 27-18.9-2
Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
Barber: means any person who shaves or trims the beard; waves, dresses, singes, shampoos, or dyes the hair; or applies hair tonics, cosmetic preparations, antiseptics, powders, oil clays, or lotions to the scalp, face, or neck of any person; or cuts the hair of any person; gives facial and scalp massages; or treatments with oils, creams, lotions, or other preparations. See Rhode Island General Laws 5-10-1
Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
Beneficiary: has the meaning given that term under section 3(8) of the Employee Retirement Security Act of 1974, Rhode Island General Laws 27-18.6-2
Beneficiary: means a policy holder subscriber, enrollee, or other individual participating in a health benefit plan. See Rhode Island General Laws 27-18.8-2
Beneficiary: means a policy-holder subscriber, enrollee, or other individual participating in a health-benefit plan. See Rhode Island General Laws 27-18.9-2
Benefit determination: means a decision to approve or deny a request to provide or make payment for a healthcare service. See Rhode Island General Laws 27-18.8-2
Benefit determination: means a decision to approve or deny a request to provide or make payment for a healthcare service or treatment. See Rhode Island General Laws 27-18.9-2
Board: means the state board of barbering and hairdressing as provided for in this chapter. See Rhode Island General Laws 5-10-1
Bona fide association: means , with respect to health insurance coverage in this state, an association which:

(i) Has been actively in existence for at least five (5) years;

(ii) Has been formed and maintained in good faith for purposes other than obtaining insurance;

(iii) Does not condition membership in the association on any health status-relating factor relating to an individual (including an employee of an employer or a dependent of an employee);

(iv) Makes health insurance coverage offered through the association available to all members regardless of any health status-related factor relating to the members (or individuals eligible for coverage through a member);

(v) Does not make health insurance coverage offered through the association available other than in connection with a member of the association;

(vi) Is composed of persons having a common interest or calling;

(vii) Has a constitution and bylaws; and

(viii) Meets any additional requirements that the director may prescribe by regulation;

(4) "COBRA continuation provision" means any of the following:

(i) Section 4980(B) of the Internal Revenue Code of 1986, Rhode Island General Laws 27-18.6-2
carrier: means any entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the director, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including, without limitation, an insurance company offering accident and sickness insurance, a health maintenance organization, a nonprofit hospital, medical or dental service corporation, or any other entity providing a plan of health insurance or health benefits by which healthcare services are paid or financed for an eligible individual or his or her dependents by such entity on the basis of a periodic premium, paid directly or through an association, trust, or other intermediary, and issued, renewed, or delivered within or without Rhode Island to cover a natural person who is a resident of this state, including a certificate issued to a natural person that evidences coverage under a policy or contract issued to a trust or association;

(9)(i) "Health insurance coverage" means a policy, contract, certificate, or agreement offered by a health insurance carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services. See Rhode Island General Laws 27-18.5-2
carrier: means any entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the director, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including, without limitation, an insurance company offering accident and sickness insurance, a health maintenance organization, a nonprofit hospital, medical or dental service corporation, or any other entity providing a plan of health insurance, health benefits, or health services;

(15)(i) "Health insurance coverage" means a policy, contract, certificate, or agreement offered by a health insurance carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. See Rhode Island General Laws 27-18.6-2
Certificate: means a certificate granted by the commissioner to a healthcare entity meeting the requirements of this chapter. See Rhode Island General Laws 27-18.8-2
Certificate: means a certificate granted by the commissioner to a review agent meeting the requirements of this chapter. See Rhode Island General Laws 27-18.9-2
Certified registered nurse practitioners: is a n expanded role utilizing independent knowledge of physical assessment and management of health care and illnesses. See Rhode Island General Laws 27-20-1
Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
Church plan: has the meaning given that term under section 3(33) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Claim: means a request for plan benefit(s) made by a claimant in accordance with the healthcare entity's reasonable procedures for filing benefit claims. See Rhode Island General Laws 27-18.9-2
Claimant: means a healthcare entity participant, beneficiary, and/or authorized representative who makes a request for plan benefit(s). See Rhode Island General Laws 27-18.9-2
Class of creditors: means :

(i) All voting policyholders, including those without known claims;

(ii) Voting creditors, other than policyholders; or

(iii) Any separate class of creditors as the court may in its discretion determine should approve the commutation plan. See Rhode Island General Laws 27-14.5-1
Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
Commercial run-off insurer: means :

(i) A run-off insurer domiciled in Rhode Island, or the protected cell of the insurer, whose business, excluding all business subject to an assumption reinsurance agreement, includes only the reinsuring of any line(s) of business other than life and/or the insuring of any line(s) of business other than life, workers' compensation, and personal lines insurance; or

(ii) A Rhode Island domestic insurance company, or the protected cell of that insurer, meeting the requirements of subsection (i) whose liabilities consist of commercial liabilities transferred to said company with the approval of the commissioner and pursuant to the regulations issued by the department under this chapter. See Rhode Island General Laws 27-14.5-1
Commissioner: means the director of the department. See Rhode Island General Laws 27-14.5-1
Commissioner: means the health insurance commissioner;

(4) "Creditable coverage" has the same meaning as defined in the United States Public Health Service Act, Section 2701(c), Rhode Island General Laws 27-18.5-2
Commissioner: means the commissioner of the office of the health insurance commissioner. See Rhode Island General Laws 27-18.8-2
Commissioner: means the health insurance commissioner. See Rhode Island General Laws 27-18.9-2
Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
Commutation plan: means a plan for extinguishing the outstanding liabilities of a commercial run-off insurer. See Rhode Island General Laws 27-14.5-1
Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
Concurrent claim: means a request for a plan benefit(s) by a claimant that is for an ongoing course of treatment or services over a period of time or for the number of treatments. See Rhode Island General Laws 27-18.9-2
Continuance: Putting off of a hearing ot trial until a later time.
Contract: A legal written agreement that becomes binding when signed.
Contracting hospital: means an eligible hospital that has contracted with a nonprofit hospital service corporation to render hospital care to subscribers to the nonprofit hospital service plan operated by the corporation. See Rhode Island General Laws 27-19-1
Conviction: A judgement of guilt against a criminal defendant.
Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
Counselor in mental health: means a person who has been licensed pursuant to §?5-63. See Rhode Island General Laws 27-20-1
covered benefits: means coverage or benefits for the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body including coverage or benefits for transportation primarily for and essential thereto, and including medical services as defined in § 27-19-17;

(9) "Healthcare facility" means an institution providing healthcare services or a healthcare setting, including, but not limited to, hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, residential treatment centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings. See Rhode Island General Laws 27-18-1.1
covered benefits: means coverage or benefits for the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body including coverage or benefits for transportation primarily for and essential thereto, and including medical services as defined in § 27-19-17. See Rhode Island General Laws 27-19-1
covered benefits: means coverage or benefits for the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body including coverage or benefits for transportation primarily for and essential thereto, and including medical services as defined in §?27-19-17. See Rhode Island General Laws 27-20-1
Creditor: means :

(i) Any person who has a claim against the applicant; or

(ii) A policyholder other than an assumption policyholder. See Rhode Island General Laws 27-14.5-1
Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
Delegate: means a person or entity authorized pursuant to a delegation of authority or directly or re-delegation of authority, by a healthcare entity or network plan to perform one or more of the functions and responsibilities of a healthcare entity and/or network plan set forth in this chapter or regulations or guidance promulgated thereunder. See Rhode Island General Laws 27-18.8-2
Department: means the Rhode Island department of health. See Rhode Island General Laws 5-10-1
Department: means the department of business regulation. See Rhode Island General Laws 27-14.5-1
Dependent: A person dependent for support upon another.
Director: means the director of the department of business regulation;

(6) "Eligible individual" means an individual:

(i) For whom, as of the date on which the individual seeks coverage under this chapter, the aggregate of the periods of creditable coverage is eighteen (18) or more months and whose most recent prior creditable coverage was under a group health plan, a governmental plan established or maintained for its employees by the government of the United States or by any of its agencies or instrumentalities, or church plan (as defined by the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.5-2
Director: means the director of the department of business regulation;

(8) "Employee" has the meaning given that term under section 3(6) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
Division: means the division of professional regulation within the department of health. See Rhode Island General Laws 5-10-1
Docket: A log containing brief entries of court proceedings.
Donor: The person who makes a gift.
Employee: has the meaning given that term under section 3(6) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Employer: has the meaning given that term under section 3(5) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Enrollment date: means , with respect to an individual covered under a group health plan or health insurance coverage, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period for the enrollment;

(11) "Governmental plan" has the meaning given that term under section 3(32) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
Esthetician: means a person who engages in the practice of esthetics, and is licensed as an esthetician. See Rhode Island General Laws 5-10-1
Esthetics: means the practice of cleansing, stimulating, manipulating, and beautifying skin, including, but not limited to, the treatment of such skin problems as dehydration, temporary capillary dilation, excessive oiliness, and clogged pores. See Rhode Island General Laws 5-10-1
Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
Executor: A male person named in a will to carry out the decedent
External review: means a review of a non-administrative adverse benefit determination (including final internal adverse benefit determination) conducted pursuant to an applicable external review process performed by an independent review organization. See Rhode Island General Laws 27-18.9-2
External review decision: means a determination by an independent review organization at the conclusion of the external review. See Rhode Island General Laws 27-18.9-2
Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
Fiduciary: A trustee, executor, or administrator.
Fraud: Intentional deception resulting in injury to another.
Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
Governmental plan: has the meaning given that term under section 3(32) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. ^{Source: Federal Reserve}
Grandfathered health plan: means any group health plan or health insurance coverage subject to Rhode Island General Laws 27-18-1.1
Grandfathered health plan: means any group health plan or health insurance coverage subject to Rhode Island General Laws 27-19-1
Grandfathered health plan: means any group health plan or health insurance coverage subject to Rhode Island General Laws 27-20-1
Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with such plan. See Rhode Island General Laws 27-18-1.1
Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with that plan;

(13) "Group health plan" means an employee welfare benefits plan as defined in section 3(1) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with the plan. See Rhode Island General Laws 27-19-1
Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with such plan. See Rhode Island General Laws 27-20-1
Group health plan: means an employee welfare benefit plan, as defined in Rhode Island General Laws 27-18-1.1
Group health plan: means an employee welfare benefit plan as defined in section 3(1) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.5-2
Group health plan: means an employee welfare benefit plan, as defined in Rhode Island General Laws 27-19-1
Group health plan: means an employee welfare benefit plan as defined in Rhode Island General Laws 27-20-1
Guarantee association: means a guarantee association or foreign guarantee association, as those terms are defined in Rhode Island General Laws 27-14.5-1
Guarantor: A party who agrees to be responsible for the payment of another party's debts should that party default. ^{Source: OCC}
Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
Hairdresser and cosmetician: means any person who arranges, dresses, curls, cuts, waves, singes, bleaches, or colors the hair or treats the scalp, or manicures the nails of any person, either with or without compensation, or who, by the use of the hands or appliances, or of cosmetic preparations, antiseptics, tonics, lotions, creams, powders, oils or clays, engages, with or without compensation, in massaging, cleansing, stimulating, manipulating, exercising, or beautifying, or in doing similar work upon the neck, face, or arms, or who removes superfluous hair from the body of any person. See Rhode Island General Laws 5-10-1
health benefit plan: means health insurance coverage and a group health plan, including coverage provided through an association plan if it covers Rhode Island residents. See Rhode Island General Laws 27-18-1.1
health benefit plan: means health insurance coverage and a group health plan, including coverage provided through an association plan if it covers Rhode Island residents. See Rhode Island General Laws 27-19-1
health benefit plan: means health insurance coverage and a group health plan, including coverage provided through an association plan if it covers Rhode Island residents. See Rhode Island General Laws 27-20-1
Health insurance carrier: means a person, firm, corporation or other entity subject to the jurisdiction of the commissioner under this chapter. See Rhode Island General Laws 27-18-1.1
Health insurance carrier: means a person, firm, corporation, or other entity subject to the jurisdiction of the commissioner under this chapter, and includes nonprofit hospital service corporations. See Rhode Island General Laws 27-19-1
Health insurance carrier: means a person, firm, corporation, or other entity subject to the jurisdiction of the commissioner under this chapter, and includes a nonprofit medical service corporation. See Rhode Island General Laws 27-20-1
health insurance commissioner: means that individual appointed pursuant to Rhode Island General Laws 27-18-1.1
health insurance commissioner: means that individual appointed pursuant to Rhode Island General Laws 27-19-1
health insurance commissioner: means that individual appointed pursuant to §?42-14. See Rhode Island General Laws 27-20-1
health plan: means a policy, contract, certificate, or agreement entered into, offered, or issued by a healthcare entity to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services. See Rhode Island General Laws 27-18.8-2
health plan: means a policy, contract, certificate, or agreement entered into, offered, or issued by a healthcare entity to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services. See Rhode Island General Laws 27-18.9-2
Health status-related factor: means any of the following factors:

(i) Health status;

(ii) Medical condition, including both physical and mental illnesses;

(iii) Claims experience;

(iv) Receipt of health care;

(v) Medical history;

(vi) Genetic information;

(vii) Evidence of insurability, including conditions arising out of acts of domestic violence; and

(viii) Disability;

(11) "High-risk individuals" means those individuals who do not pass medical underwriting standards due to high healthcare needs or risks;

(12) "Individual market" means the market for health insurance coverage offered to individuals other than in connection with a group health plan;

(13) "Network plan" means health insurance coverage offered by a health insurance carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier;

(14) "Preexisting condition" means, with respect to health insurance coverage, a condition (whether physical or mental), regardless of the cause of the condition, that was present before the date of enrollment for the coverage, for which medical advice, diagnosis, care, or treatment was recommended or received within the six-month (6) period ending on the enrollment date. See Rhode Island General Laws 27-18.5-2
Health status-related factor: means any of the following factors:

(i) Health status;

(ii) Medical condition, including both physical and mental illnesses;

(iii) Claims experience;

(iv) Receipt of health care;

(v) Medical history;

(vi) Genetic information;

(vii) Evidence of insurability, including contributions arising out of acts of domestic violence; and

(viii) Disability;

(18) "Large employer" means, in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least fifty-one (51) employees on business days during the preceding calendar year and who employs at least two (2) employees on the first day of the plan year. See Rhode Island General Laws 27-18.6-2
Healthcare entity: means an insurance company licensed, or required to be licensed, by the state of Rhode Island or other entity subject to the jurisdiction of the commissioner or the jurisdiction of the department of business regulation that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including, without limitation: a for-profit or nonprofit hospital, medical or dental service corporation or plan, a health maintenance organization, a health insurance company, or any other entity providing health insurance, accident and sickness insurance, health benefits, or healthcare services. See Rhode Island General Laws 27-18.8-2
Healthcare entity: means an insurance company licensed, or required to be licensed, by the state of Rhode Island or other entity subject to the jurisdiction of the commissioner or the jurisdiction of the department of business regulation pursuant to chapter 62 of Title 42, that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including, without limitation: a for-profit or nonprofit hospital, medical or dental service corporation or plan, a health maintenance organization, a health insurance company, or any other entity providing a plan of health insurance, accident and sickness insurance, health benefits, or healthcare services. See Rhode Island General Laws 27-18.9-2
Healthcare facility: means an institution providing healthcare services or a healthcare setting, including but not limited to: hospitals and other licensed inpatient centers; ambulatory surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic, laboratory, and imaging centers; and rehabilitation and other therapeutic health settings. See Rhode Island General Laws 27-19-1
Healthcare facility: means an institution providing healthcare services or a healthcare setting, including but not limited to: hospitals and other licensed inpatient centers; ambulatory surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic, laboratory, and imaging centers; and rehabilitation and other therapeutic health settings. See Rhode Island General Laws 27-20-1
Healthcare professional: means a physician or other healthcare practitioner licensed, accredited or certified to perform specified healthcare services consistent with state law. See Rhode Island General Laws 27-18-1.1
Healthcare professional: means a physician or other healthcare practitioner licensed, accredited, or certified to perform specified healthcare services consistent with state law. See Rhode Island General Laws 27-19-1
Healthcare professional: means a physician or other healthcare practitioner licensed, accredited, or certified to perform specified healthcare services consistent with state law. See Rhode Island General Laws 27-20-1
Healthcare services: means services for the diagnosis, prevention, treatment, cure or relief of a health condition, illness, injury or disease. See Rhode Island General Laws 27-18-1.1
Healthcare services: means and includes, but is not limited to: an admission, diagnostic procedure, therapeutic procedure, treatment, extension of stay, the ordering and/or filling of formulary or non-formulary medications, and any other medical, behavioral, dental, vision care services, activities, or supplies that are covered by the beneficiary's health benefit plan. See Rhode Island General Laws 27-18.8-2
Healthcare services: means and includes, but is not limited to: an admission, diagnostic procedure, therapeutic procedure, treatment, extension of stay, the ordering and/or filling of formulary or non-formulary medications, and any other medical, behavioral, dental, vision care services, activities, or supplies that are covered by the beneficiary's health-benefit plan. See Rhode Island General Laws 27-18.9-2
Healthcare services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Rhode Island General Laws 27-19-1
Healthcare services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Rhode Island General Laws 27-20-1
Implementation order: means an order under Rhode Island General Laws 27-14.5-1
in writing: include printing, engraving, lithographing, and photo-lithographing, and all other representations of words in letters of the usual form. See Rhode Island General Laws 43-3-16
Instructor: means any person licensed as an instructor under the provisions of this chapter. See Rhode Island General Laws 5-10-1
insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under the policy to any indemnities, benefits, and rights provided in the policy. See Rhode Island General Laws 27-18-7
Insurer: has the meaning given in Rhode Island General Laws 27-14.5-1
internal appeal: means a subsequent review of an adverse benefit determination upon request by a claimant to include the beneficiary or provider to reconsider all or part of the original adverse benefit determination. See Rhode Island General Laws 27-18.9-2
Interrogatories: Written questions asked by one party of an opposing party, who must answer them in writing under oath; a discovery device in a lawsuit.
IRO: means an entity that conducts independent external reviews of adverse benefit determinations or final internal adverse benefit determinations. See Rhode Island General Laws 27-18.9-2
Judgement: The official decision of a court finally determining the respective rights and claims of the parties to a suit.
Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
Large group market: means the health insurance market under which individuals obtain health insurance coverage (directly or through any arrangement) on behalf of themselves (and their dependents) through a group health plan maintained by a large employer;

(20) "Late enrollee" means, with respect to coverage under a group health plan, a participant or beneficiary who enrolls under the plan other than during:

(i) The first period in which the individual is eligible to enroll under the plan; or

(ii) A special enrollment period;

(21) "Medical care" means amounts paid for:

(i) The diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body;

(ii) Amounts paid for transportation primarily for and essential to medical care referred to in paragraph (i) of this subdivision; and

(iii) Amounts paid for insurance covering medical care referred to in paragraphs (i) and (ii) of this subdivision;

(22) "Network plan" means health insurance coverage offered by a health insurance carrier under which the financing and delivery of medical care including items and services paid for as medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier;

(23) "Participant" has the meaning given such term under section 3(7) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
Licensed midwife: means any midwife licensed under §?23-13-9. See Rhode Island General Laws 27-20-1
Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
Manicurist: means any person who engages in manicuring for compensation and is duly licensed as a manicurist. See Rhode Island General Laws 5-10-1
Medical services: as used in this chapter means professional services rendered by physicians, dentists, podiatrists, or other providers of health services for any medical, dental, surgical, and other health services as may lawfully be rendered by them to subscribers; the term includes appliances, drugs, medicines, supplies, and nursing care necessary in connection with those services, or the expense indemnity for those services, appliances, drugs, medicines, supplies, and care, as may be specified in any nonprofit medical service plan. See Rhode Island General Laws 27-19-17
Medical services: means those professional services rendered by persons duly licensed under the laws of this state to practice medicine, surgery, chiropractic, podiatry, and other professional services rendered by a licensed midwife, certified registered nurse practitioners, and psychiatric and mental health nurse clinical specialists, and appliances, drugs, medicines, supplies, and nursing care necessary in connection with the services, or the expense indemnity for the services, appliances, drugs, medicines, supplies, and care, as may be specified in any nonprofit medical service plan. See Rhode Island General Laws 27-20-1
Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
Mortgage loan: A loan made by a lender to a borrower for the financing of real property. ^{Source: OCC}
Most-favored-rate clause: means a provision in a provider contract whereby the rates or fees to be paid by a healthcare entity are fixed, established, or adjusted to be equal to or lower than the rates or fees paid to the provider by any other healthcare entity. See Rhode Island General Laws 27-18.8-2
Network: means the group or groups of participating providers providing healthcare services under a network plan. See Rhode Island General Laws 27-18.8-2
Network: means the group or groups of participating providers providing healthcare services under a network plan. See Rhode Island General Laws 27-18.9-2
Network plan: means a health benefit plan or health plan that either requires a beneficiary to use, or creates incentives, including financial incentives, for a beneficiary to use the providers managed, owned, under contract with, or employed by the healthcare entity. See Rhode Island General Laws 27-18.8-2
Network plan: means a health-benefit plan or health plan that either requires a beneficiary to use, or creates incentives, including financial incentives, for a beneficiary to use the providers managed, owned, under contract with, or employed by the healthcare entity. See Rhode Island General Laws 27-18.9-2
Nonprofit hospital service corporation: means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining, and operating a nonprofit hospital service plan. See Rhode Island General Laws 27-19-1
Nonprofit hospital service plan: means a plan by which specified hospital care is to be provided to subscribers to the plan by a contracting hospital. See Rhode Island General Laws 27-19-1
Nonprofit medical service corporation: means any corporation organized pursuant hereto for the purpose of establishing, maintaining, and operating a nonprofit medical service plan. See Rhode Island General Laws 27-20-1
Nonprofit medical service plan: means a plan by which specified medical service is provided to subscribers to the plan by a nonprofit medical service corporation. See Rhode Island General Laws 27-20-1
Nonprofit optometric service corporation: means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining, and operating a nonprofit optometric service plan. See Rhode Island General Laws 27-20.2-1
Nonprofit optometric service plan: means a plan by which specified optometric service is provided to subscribers to the plan by a nonprofit optometric service corporation. See Rhode Island General Laws 27-20.2-1
Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
Office: means the office of the health insurance commissioner. See Rhode Island General Laws 27-18.8-2
Office: means the office of the health insurance commissioner. See Rhode Island General Laws 27-18.9-2
Office of the health insurance commissioner: means the agency established under Rhode Island General Laws 27-18-1.1
Office of the health insurance commissioner: means the agency established under Rhode Island General Laws 27-19-1
Office of the health insurance commissioner: means the agency established under §?42-14. See Rhode Island General Laws 27-20-1
Optometric service: means the professional services rendered by persons duly licensed under the laws of this state to practice optometry or the expense indemnity for the services, appliances, supplies, and care as may be specified in any nonprofit optometric service plan. See Rhode Island General Laws 27-20.2-1
Oversight: Committee review of the activities of a Federal agency or program.
Participant: has the meaning given such term under section 3(7) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
Person: means an individual, corporation, partnership, association, joint stock company, trust, unincorporated organization, or any similar entity or any combination of the foregoing acting in concert. See Rhode Island General Laws 27-14.5-1
person: may be construed to extend to and include co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6
Personal lines insurance: means insurance issued for personal, family, or household purposes. See Rhode Island General Laws 27-14.5-1
Placed for adoption: means , in connection with any placement for adoption of a child with any person, the assumption and retention by that person of a legal obligation for total or partial support of the child in anticipation of adoption of the child. See Rhode Island General Laws 27-18.6-2
Plaintiff: The person who files the complaint in a civil lawsuit.
Plan sponsor: has the meaning given that term under section 3(16)(B) of the Employee Retirement Income Security Act of 1974, Rhode Island General Laws 27-18.6-2
Policy: means a contract of insurance or a contract of reinsurance. See Rhode Island General Laws 27-14.5-1
Policy of accident and sickness insurance: as used in this chapter , includes any policy or contract covering against loss resulting from sickness or from bodily injury or death by accident, or both. See Rhode Island General Laws 27-18-1
Policyholder: means an insured or a reinsured of the insurer. See Rhode Island General Laws 27-14.5-1
Practice of barbering: means the engaging by any licensed barber in all, or any combination of, the following practices: shaving or trimming the beard or cutting the hair; giving facial and scalp massages or treatments with oils, creams, lotions, or other preparations, either by hand or mechanical appliances; singeing, shampooing, arranging, dressing, curling, waving, chemical waving, hair relaxing, or dyeing the hair or applying hair tonics; or applying cosmetic preparations, antiseptics, powders, oils, clays, or lotions to the scalp, face, or neck. See Rhode Island General Laws 5-10-1
Practice of hairdressing and cosmetic therapy: means the engaging by any licensed hairdresser and cosmetician in any one or more of the following practices: the application of the hands or of mechanical or electrical apparatus, with or without cosmetic preparations, tonics, lotions, creams, antiseptics, or clays, to massage, cleanse, stimulate, manipulate, exercise, or otherwise to improve or to beautify the scalp, face, neck, shoulders, arms, bust, or upper part of the body; or the manicuring of the nails of any person; or the removing of superfluous hair from the body of any person; or the arranging, dressing, curling, waving, weaving, cleansing, cutting, singeing, bleaching, coloring, or similarly treating the hair of any person. See Rhode Island General Laws 5-10-1
Practice of manicuring: means the cutting, trimming, polishing, tinting, coloring, or cleansing the nails of any person. See Rhode Island General Laws 5-10-1
Pre-service claim: means the request for a plan benefit(s) by a claimant prior to a service being rendered and is not considered a concurrent claim. See Rhode Island General Laws 27-18.9-2
Preexisting condition exclusion: means , with respect to health insurance coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for the coverage, whether or not any medical advice, diagnosis, care or treatment was recommended or received before the date; and

(27) "Waiting period" means, with respect to a group health plan and an individual who is a potential participant or beneficiary in the plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan. See Rhode Island General Laws 27-18.6-2
Professional provider: means an individual provider or healthcare professional licensed, accredited, or certified to perform specified healthcare services consistent with state law and who provides these healthcare services and is not part of a separate facility or institutional contract. See Rhode Island General Laws 27-18.8-2
Professional provider: means an individual provider or healthcare professional licensed, accredited, or certified to perform specified healthcare services consistent with state law and who provides healthcare services and is not part of a separate facility or institutional contract. See Rhode Island General Laws 27-18.9-2
Proportionate share: means , for a particular run-off insurer as of December 31 of the previous year, the ratio of:

(i) The gross assets of that run-off insurer; to

(ii) The gross assets of all run-off insurers, other than those that were not domiciled in Rhode Island on March 15 of that calendar year. See Rhode Island General Laws 27-14.5-1
Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
provider: means a healthcare professional or a healthcare facility. See Rhode Island General Laws 27-18-1.1
Provider: means a physician, hospital, professional provider, pharmacy, laboratory, dental, medical, or behavioral health provider, or other state-licensed or other state-recognized provider of health care or behavioral health services or supplies. See Rhode Island General Laws 27-18.8-2
Provider: means a physician, hospital, professional provider, pharmacy, laboratory, dental, medical, or behavioral health provider or other state-licensed or other state-recognized provider of health care or behavioral health services or supplies. See Rhode Island General Laws 27-18.9-2
provider: means a healthcare professional or a healthcare facility. See Rhode Island General Laws 27-19-1
provider: means a healthcare professional or a healthcare facility. See Rhode Island General Laws 27-20-1
Psychiatric and mental health nurse clinical specialist: is a n expanded role utilizing independent knowledge and management of mental health and illnesses. See Rhode Island General Laws 27-20-1
Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. ^{Source: FDIC}
Redomestication expenditure: means , for any calendar year:

(i) The amount that the department's expenditures attributable to the regulation of run-off insurers increases as a result of any run-off insurer redomiciling to Rhode Island on or after March 15 of that year; less

(ii) Filing fees, examination costs, and any other fees in relation to insurance regulation in this state paid to this state by run-off insurers that redomiciled to Rhode Island on or after March 15 of that year, but excluding any premium taxes. See Rhode Island General Laws 27-14.5-1
Regulatory expenditure: means , for any calendar year:

(i) The amount of the department's expenditures attributable to the regulation of run-off insurers domiciled in Rhode Island on March 15 of that year; less

(ii) Filing fees, examination costs, and any other fees in relation to insurance regulation in this state paid to this state by run-off insurers domiciled in Rhode Island on March 15 of that year, but excluding any premium taxes. See Rhode Island General Laws 27-14.5-1
Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
Rescission: means a cancellation or discontinuance of coverage that has retroactive effect for reasons unrelated to timely payment of required premiums or contribution to costs of coverage. See Rhode Island General Laws 27-18-1.1
Rescission: means a cancellation or discontinuance of coverage that has retroactive effect for reasons unrelated to timely payment of required premiums or contribution to costs of coverage. See Rhode Island General Laws 27-19-1
Rescission: means a cancellation or discontinuance of coverage that has retroactive effect for reasons unrelated to timely payment of required premiums or contribution to costs of coverage. See Rhode Island General Laws 27-20-1
Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
Review agent: means a person or healthcare entity performing benefit determination reviews that is either employed by, affiliated with, under contract with, or acting on behalf of a healthcare entity. See Rhode Island General Laws 27-18.9-2
Run-off insurer: means an insurer that:

(i) Is domiciled in Rhode Island;

(ii) Has liabilities under policies for property and casualty lines of business;

(iii) Has ceased underwriting new business; and

(iv) Is only renewing ongoing business to the extent required by law or by contract. See Rhode Island General Laws 27-14.5-1
Same or similar specialty: means a practitioner who has the appropriate training and experience that is the same or similar as the attending provider in addition to experience in treating the same problems to include any potential complications as those under review. See Rhode Island General Laws 27-18.9-2
School: means a school approved under chapter 40 of Title 16, as amended, devoted to the instruction in, and study of, the theory and practice of barbering, hairdressing, and cosmetic therapy, esthetics, and/or manicuring. See Rhode Island General Laws 5-10-1
Service of process: The service of writs or summonses to the appropriate party.
Statute: A law passed by a legislature.
Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
Subpoena: A command to a witness to appear and give testimony.
Subscribers: as used in this chapter includes, in addition to those set forth in § 27-19-1, persons contracting with the corporation for coverage or benefits for medical services. See Rhode Island General Laws 27-19-17
Subscribers: means those persons or groups of persons who contract with a nonprofit medical service corporation for medical service pursuant to a nonprofit medical service plan. See Rhode Island General Laws 27-20-1
Subscribers: means those persons or groups of persons who contract with a nonprofit optometric service corporation for optometric service pursuant to a nonprofit optometric service plan. See Rhode Island General Laws 27-20.2-1
Testify: Answer questions in court.
Testimony: Evidence presented orally by witnesses during trials or before grand juries.
Therapeutic interchange: means the interchange or substitution of a drug with a dissimilar chemical structure within the same therapeutic or pharmacological class that can be expected to have similar outcomes and similar adverse reaction profiles when given in equivalent doses, in accordance with protocols approved by the president of the medical staff or medical director and the director of pharmacy. See Rhode Island General Laws 27-18.9-2
Therapist in marriage and family practice: means a person who has been licensed pursuant to §?5-63. See Rhode Island General Laws 27-20-1
town: may be construed to include city; the words "town council" include city council; the words "town clerk" include city clerk; the words "ward clerk" include clerk of election district; the words "town treasurer" include city treasurer; and the words "town sergeant" include city sergeant. See Rhode Island General Laws 43-3-9
Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
United States: include the several states and the territories of the United States. See Rhode Island General Laws 43-3-8
Uphold: The decision of an appellate court not to reverse a lower court decision.
Utilization review: means the prospective, concurrent, or retrospective assessment of the medical necessity and/or appropriateness of the allocation of healthcare services of a provider, given or proposed to be given, to a beneficiary. See Rhode Island General Laws 27-18.9-2
Venue: The geographical location in which a case is tried.
Voluntary restructuring: means the act of reorganizing the legal ownership, operational, governance, or other structures of a solvent insurer, for the purpose of enhancing organization and maximizing efficiencies, and shall include the transfer of assets and liabilities to or from an insurer, or the protected cell of an insurer pursuant to an insurance business transfer plan. See Rhode Island General Laws 27-14.5-1
Wellness health benefit plan: means that health benefit plan offered in the individual market pursuant to Rhode Island General Laws 27-18.5-2
Writ: A formal written command, issued from the court, requiring the performance of a specific act.