Medicaid Managed Care Contracts & Policy/Guidance Documents

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)

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)

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)

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)

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

 

RI Medicaid Managed Care Quality Strategy

 

Accountable Entities Implementation Manual

 

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

2023 State Medicaid Agency D-SNP Agreements