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)

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)

Three Way Contract (07/01/2022)

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)

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 (10/2021)

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

• 2023 State Medicaid Agency D-SNP Agreement RI – Blue Cross Blue Shield of Rhode Island (H4152-021)

• 2023 State Medicaid Agency D-SNP Agreement RI – Commonwealth Care Alliance (H0876-001)

• 2023 State Medicaid Agency D-SNP Agreement RI – WellCare (H4699-003, H4699-005)

• 2023 State Medicaid Agency D-SNP Agreement RI – Oxford Health Plans (H3113-010)

• 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)

• 2022 State Medicaid Agency DSNP Agreement RI - Commonwealth Care Alliance (06/2021)

• 2022 State Medicaid Agency DSNP Agreement RI - WellCare Health Plans of Rhode Island, Inc (06/2021)

• 2022 State Medicaid Agency DSNP Agreement RI - United Healthcare (Oxford Health Plans, Inc.) (06/2021)