Official State of Rhode Island website

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

Medicaid Managed Care Contracts & Policy/Guidance Documents

THPP 2017-16B Amendment 16B (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 2017-12B Amendment 12B (06/03/2024)

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

       THPP 2017-14 Amendment 14 (08/09/2024)

       THPP 2017-15 Amendment 15 (11/14/2024)

       THPP 2017-15B Amendment 15B (04/07/2025)

       THPP 2017-16 Amendment 16 (12/16/2024)

       THPP 2017-16B Amendment 16B (04/07/2025)

UHC 2017-16B Amendment 16B (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 2017-12B Amendment 12B (06/03/2024)

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

       UHC 2017-14 Amendment 14 (08/09/2024)

       UHC 2017-15 Amendment 15 (11/14/2024)

       UHC 2017-15B Amendment 15B (04/07/2025)

       UHC 2017-16 Amendment 16 (12/16/2024)

       UHC 2017-16B Amendment 16B (04/07/2025)

NHPRI 2017-16B Amendment 16B (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 2017-12B Amendment 12B (06/03/2024)

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

       NHPRI 2017-14 Amendment 14 (08/09/2024)

       NHPRI 2017-15 Amendment 15 (11/14/2024)

       NHPRI 2017-15B Amendment 15B (04/07/2025)

       NHPRI 2017-16 Amendment 16 (12/16/2024)

       NHPRI 2017-16B Amendment 16B (04/07/2025)

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 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

2025 State Medicaid Agency D-SNP Agreements