Medicaid Managed Care Contracts & Policy/Guidance Documents

THPP 2017-13 Amendment 13 (Full Contract)

       THPP 2017-01 Amendment 1 (11/08/2018)

                 Base Contract, Addendums, Attachments

       THPP 2017-02 Amendment 2 (01/08/2019)

                 Base Contract, Addendums, Attachments

       THPP 2017-03 Amendment 3 (09/23/2019)

                 Base Contract, Addendums, Attachments

       THPP 2017-04 Amendment 4 (04/08/2021)

       THPP 2017-05 Amendment 5 (10/20/2021)

       THPP 2017-06 Amendment 6 (03/20/2022)

       THPP 2017-07 Amendment 7 (07/13/2022)

       THPP 2017-08 Amendment 8 (07/26/2022)

       THPP 2017-09 Amendment 9 (09/28/2022)

       THPP 2017-09B Amendment 9B (10/24/2023)

       THPP 2017-10 Amendment 10 (06/15/2023)

       THPP 2017-11 Amendment 11 (08/15/2023)

       THPP 2017-12 Amendment 12 (10/24/2023)

       THPP-2017-13 Amendment 13 (10/24/2023)

UHC 2017-13 Amendment 13 (Full Contract)

       UHC 2017-01 Amendment 1 

                 Base Contract, Addendums, Attachments

       UHC 2017-02 Amendment 2 (02/15/2019)

                 Base Contract, Addendums, Attachments

       UHC 2017-03 Amendment 3 (10/10/2019)

                 Base Contract, Addendums, Attachments

       UHC 2017-04 Amendment 4 (04/08/2021)

       UHC 2017-05 Amendment 5 (10/06/2021)

       UHC 2017-06 Amendment 6 (03/29/2022)

       UHC 2017-07 Amendment 7 (08/10/2022)

       UHC 2017-08 Amendment 8 (08/10/2022)

       UHC 2017-09 Amendment 9 (09/28/2022)

       UHC 2017-09B Amendment 9B (10/24/2023)

       UHC 2017-10 Amendment 10 (06/15/2023)

       UHC 2017-11 Amendment 11 (08/09/2023)

       UHC 2017-12 Amendment 12 (10/24/2023)

       UHC 2017-13 Amendment 13 (10/24/2023)

NHPRI 2017-13 Amendment 13 (Full Contract)

       NHPRI 2017-01 Amendment 1 (10/03/2018)

                 Base Contract, Addendums, Attachments

       NHPRI 2017-02 Amendment 2 (02/15/2019)

                 Base Contract, Addendums, Attachments

       NHPRI 2017-03 Amendment 3 (09/23/2019)

                 Base Contract, Addendums, Attachments

       NHPRI 2017-04 Amendment 4 (04/20/2021)

       NHPRI 2017-05 Amendment 5 (10/20/2021)

       NHPRI 2017-06 Amendment 6 (03/30/2022)

       NHPRI 2017-07 Amendment 7 (08/10/2022)

       NHPRI 2017-08 Amendment 8 (08/10/2022)

       NHPRI 2017-09 Amendment 9 (10/03/2022)

       NHPRI 2017-09B Amendment 9B (10/24/2023)

       NHPRI 2017-10 Amendment 10 (06/13/2023)

       NHPRI 2017-11 Amendment 11 (08/09/2023)

       NHPRI 2017-12 Amendment 12 (10/24/2023)

       NHPRI 2017-13 Amendment 13 (11/14/2023)

UHC RIte Smiles Amendment 5 (Full Contract)

       UHC-RIte Smiles Amendment 1 (10/15/2020)

       UHC-RIte Smiles Amendment 2 (10/06/2021)

       UHC-RIte Smiles Amendment 3 (08/10/2022)

       UHC-RIte Smiles Amendment 4 (06/14/2023)

       UHC-RIte Smiles Amendment 5 (07/18/2023)

  

RIte Smiles Liquidated Damages Memo (06/2021)

Three Way Contract (07/01/2022)

Amendment (07/01/2023)

MTM 2023-01 Amendment 1 (Full Contract)

        MTM 2023-01 Amendment 1 (10/10/2023)

 

MTM CAP - Timely Notification of Critical Incidents (12/04/2023) 

Addendum A - Telemedicine Mandatory Minimum Codes V3 (10/10/2023)

Katie Beckett Care Management FAQs (10/05/2023)

Provider Screening Project FAQs (10/04/2023)

MAPCO 2023 Information (06/23/2023)

Continued Coverage of COVID-19 Testing Services & Treatments (05/11/2023)

Terminated Member Outreach Policy (05/02/2023)

21^st Century Cures Act-Provider Screening and Enrollment Compliance Deadline for Medicaid Managed Care Organizations (MCOs) (02/27/2023)

Claim Paid Date Reporting on Financial Data Reporting (11/21/2022)

Coverage of Over-the-Counter COVID-19 Tests (OTC COVID-19 Tests) – Pharmacy Benefit (01/25/2022)

Prior Authorization Suspension-Medicaid (02/04/2022)

Prior Authorization Suspension-Medicaid (01/13/2022)

Prior Authorization Suspension-Medicaid (01/06/2022)

COVID-19 Pediatric Codes (12/13/2021)

EOHHS MCO Core Contract Requirements for Reporting and Intermediate Sanctions 2020 Policy (10/2022)

EOHHS MCO Core Contract Requirements for Value Add Services (09/2021)

Value-Added Services (VAS) Request Form (09/2021)

RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program (09/2021)

EOHHS MCO Core Contract Requirements for Requesting In Lieu of Services (08/2021)

RI Medicaid Managed Care In Lieu of Services Request Form (08/2021)

Notify Medicaid Members of Impending Prior Authorization Lift (08/06/2021)

RI Medicaid Managed Care COVID-19 Model Language for the Reinstatement of PA for Members (08/2021)

Prior Authorization Requirements to be Reinstated for COVID-19 (06/2021)

RI Managed Medicaid Model Member Handbook

Appeal and Grievance Rights Template

EOHHS MCO Core Contract Requirements for Reporting Demographic Changes 2020 Policy

 

• 2024 State Medicaid Agency D-SNP Agreement RI – Blue Cross Blue Shield of Rhode Island (H4152-021)

• 2024 State Medicaid Agency D-SNP Agreement RI – Commonwealth Care Alliance (H0876-001)

• 2024 State Medicaid Agency D-SNP Agreement RI – WellCare (H4699-003, H4699-005)

• 2024 State Medicaid Agency D-SNP Agreement RI – Oxford Health Plans (H3113-010)

• 2024 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H0764-001)
• 2024 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H2272-001)