Official State of Rhode Island website

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The Executive Office of, Health and Human Services , State of Rhode Island

Medicaid Managed Care Contracts & Policy/Guidance Documents

EOHHS MCO Core Contract Requirements for Reporting and Intermediate Sanctions 2020 Policy (6/2024)

Addendum A - Telemedicine Mandatory Minimum Codes V4 (02/01/2024)

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)

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 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 Reporting Demographic Changes 2020 Policy (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

RIte Smiles Reference Materials

 

RI Medicaid Managed Care Quality Strategy

 

Accountable Entities Implementation Manual

 


Dual Special Needs (D-SNP) State Medicaid Agency Contracts

2025 State Medicaid Agency D-SNP Agreements