Medicaid Managed Care Contracts & Policy/Guidance Documents

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)

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

RIte Smiles Reference Materials

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

2023 State Medicaid Agency D-SNP Agreements

2022 State Medicaid Agency D-SNP Agreements