Medicaid Renewals Medicaid renewals began again in Rhode Island on April 1, 2023. For more information, please visit staycovered.ri.gov.
Medicaid Managed Care Contracts & Policy/Guidance Documents Tufts Health Public Plan- RI Together Contract THPP 2017-08 Amendment 9 (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) United Healthcare Community Plan of Rhode Island Contract UHC 2017-08 Amendment 9 (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) Neighborhood Health Plan of Rhode Island- Medicaid Managed Care Plan Contract NHP 2017-08 Amendment 9 (Full Contract) NHP 2017-01 Amendment 1 (10/03/2018) Base Contract, Addendums, Attachments NHP 2017-02 Amendment 2 (02/15/2019) Base Contract, Addendums, Attachments NHP 2017-03 Amendment 3 (09/23/2019) Base Contract, Addendums, Attachments NHP 2017-04 Amendment 4 (04/20/2021) NHP 2017-05 Amendment 5 (10/20/2021) NHP 2017-06 Amendment 6 (03/30/2022) NHP 2017-07 Amendment 7 (08/10/2022) NHP 2017-08 Amendment 8 (08/10/2022) NHP 2017-09 Amendment 9 (10/03/2022) United Healthcare-RIte Smiles Contract UHC RIte Smiles Amendment 2 (Full Contract) UHC-RIte Smiles Amendment 1 (10/15/2020) UHC-RIte Smiles Amendment 2 (10/06/2021) RIte Smiles Liquidated Damages Memo (06/2021) Neighborhood Health Plan of Rhode Island Medicare/Medicaid Contract Three Way Contract (07/01/2022) Medical Transportation Management Contract MTM Contract 2018 RI Transportation Brokerage Contract (9/24/2018) MTM Contract Amendments 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 1 (12/17/2018) 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 2 (2/28/2019) 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 3 (4/29/2019) 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 4 (8/9/2019) 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 5 (6/30/2020) 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 5-Part 1 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 5-Part 2 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 5-Part 3 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 5-Part 4 2018 RI Transportation Brokerage Contract Sept 2018 Amendment 6 (9/3/2021) 2018 RI Transportation Brokerage Contract Sept 2018 Standalone Amendment 7 (4/12/2022) 2018 RI Transportation Brokerage Contract Sept 2018 Full Contract Amendment 7 (4/12/2022) Medicaid Managed Care Policy and Guidance Documents Addendum A - Telemedicine Mandatory Minimum Codes V2 (06/01/2023) Continued Coverage of COVID-19 Testing Services & Treatments (05/11/2023) Terminated Member Outreach Policy (05/02/2023) 21st 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 RIte Smiles Reference Materials RIte Smiles Reference Materials RI Medicaid Managed Care Quality Strategy RI Medicaid Managed Care Quality Strategy (08-2022) Accountable Entities Implementation Manual PY5-PY6 Implementation Manual (03/01/2023) Dual Special Needs (D-SNP) State Medicaid Agency Contracts 2023 State Medicaid Agency D-SNP Agreements Blue Cross Blue Shield of Rhode Island 2023 State Medicaid Agency D-SNP Agreement RI – Blue Cross Blue Shield of Rhode Island (H4152-021) Commonwealth Care Alliance 2023 State Medicaid Agency D-SNP Agreement RI – Commonwealth Care Alliance (H0876-001) WellCare Health Plans of Rhode Island, Inc 2023 State Medicaid Agency D-SNP Agreement RI – WellCare (H4699-003, H4699-005) United Healthcare (Oxford Health Plans, Inc) 2023 State Medicaid Agency D-SNP Agreement RI – Oxford Health Plans (H3113-010) United Healthcare (United Healthcare of New England, Inc.) 2023 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H0764-001) 2023 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H2272-001)