Fair Hearing - How to Request Without Web (Mail, Call, Visit)

While the web portal (RIBridges and/or the HealthyRhode Mobile App) is not available, fair hearings can only be requested by phone, in person, or by mail. To schedule a fair hearing by phone, please call 1-855-697-4347. To request a fair hearing by mail or in person, please visit or address the materials to your local DHS office.

For more information about the fair hearing process, please visit the Appeals Office page.

Spanish

Las audiencias imparciales solo se pueden solicitar por teléfono, en persona o por correo cuando el portal web (RIBridges o la aplicación móvil HealthyRhode) no está disponible. Para programar una audiencia imparcial por teléfono, por favor llame al 1-855-697-4347. Para solicitar una audiencia imparcial por correo o en persona, por favor preséntese o envíe los materiales a la oficina del DHS más cercana (puede ver las ubicaciones aquí: https://dhs.ri.gov/office-locator-tool). Para obtener más información sobre el proceso de audiencia imparcial, por favor visite: https://eohhs.ri.gov/reference-center/eohhs-appeals-office.

Portuguese

Enquanto o portal Web (RIBridges e/ou a aplicação móvel HealthyRhode) não estiver disponível, as audiências justas só podem ser solicitadas por telefone, pessoalmente ou por correio. Para marcar uma audiência justa por telefone, ligue para 1-855-697-4347. Para solicitar uma audiência justa por correio ou pessoalmente, visite ou envie os materiais para o seu gabinete local do DHS (os locais podem ser encontrados aqui: https://dhs.ri.gov/office-locator-tool). Para mais informações sobre o processo de audiência justa, visite: https://eohhs.ri.gov/reference-center/eohhs-appeals-office.

State Innovation Model (SIM) Background

What is SIM?

In 2015, Rhode Island was one of 24 states to receive a State Innovation Model (SIM) Test Grant from the federal Centers for Medicare and Medicaid Services (CMS). The state received $20 million with the expectation that the funds would be used to transform the way healthcare is delivered and paid for. SIM funds are supporting several activities that can be broken into three categories: improving the primary care and behavioral health infrastructure, engaging patients in positive health behaviors and self-advocacy, and expanding the ability of providers and policy makers to use and share data. The belief is that by transitioning to a system of value-based care that addresses social and environmental determinants of health, SIM can support Rhode Island in enhancing the physical and behavioral health of the population, improving experience of care, and reducing the cost of healthcare.

Who is SIM?

Rhode Island SIM is led by a team of staff from several state departments, including the Executive Office of Health and Human Services, the Departments of Health, Human Services, Children Youth and Families, Behavioral Health, Developmental Disabilities and Hospitals, Medicaid, HealthSourceRI, and the Office of the Health Insurance Commissioner. SIM is also governed by a Steering Committee made up of a diverse range of stakeholders, including providers, insurers, patient advocates, and community organizations. Additional stakeholders and interested individuals are also encouraged to participate in the various working groups that SIM convenes on specific topics related to healthcare transformation.

Vision

The vision of the Rhode Island SIM Test Grant represents the desired future state resulting from a transition to value-based care in the state. Our vision statement, borrowed from the Triple Aim, reads: Continuously improving Rhode Islanders' experience of care (including quality and satisfaction), enhancing the physical and behavioral health of all Rhode Island's population, and reducing the per capita cost of healthcare for our residents.