2023 Medicaid Managed Care Procurement Library

1. Procurement, Program and Policy Information

Medicaid Managed Care Manual

Medicaid Managed Care Policy and Guidance Documents

2. Enrollment and Expenditure Information

2023

RI Medicaid Monthly Managed Care Report

EOHHS Auto Assignment Report

Termination Code Reason Report

2022

RI Medicaid Monthly Managed Care Report

EOHHS Auto Assignment Report

Termination Code Reason Report

2021

RI Medicaid Monthly Managed Care Report

EOHHS Auto Assignment Report

Termination Code Reason Report

3. Claims, Encounters, Data and Reporting

Medicaid Expenditure Report

SFY 2022 Medicaid Expenditure Report

SFY 2021 Medicaid Expenditure Repor t

SFY 2020 Medicaid Expenditure Report

SFY 2019 Medicaid Expenditure Report

Rhode Island Medicaid Managed Care Encounter Data Quality Measurement, Thresholds and Penalties for Non-Compliance

EOHHS 837 Encounter Companion Guide

SFY 2022 Medicaid Managed Care Risk Adjustment

Reporting Calendar Template

4. Population Health, Care Program and Quality

RI Medicaid Managed Care Quality Strategy (07/30/2022)

2021 External Quality Review Report

5. Provider Services

Provider Manual and Guidelines

6. EOHHS Initiatives

Accountable Entity Resources

Certified Community Behavioral Health Clinics (CCBHC)

Health Equity Zones

Health System Transformation Program Social Determinants of Health Investing Strategy

LTSS: No Wrong Door

Medicaid 1115 Demonstration Waiver

7. Rate Books

State Fiscal Year 2024

State Fiscal Year 2024 Medicaid Managed Care Capitation Rate Certification (06/23/2023)

Appendix 2 - SFY 2022 Base Data Development

Appendix 3 - Projected Benefit Expense Development

Appendix 4 - 2024 Capitation Rate Development

State Fiscal Year 2024 Medicaid Managed Care Capitation Rate Amendment (08/09/2023)

Appendix 2 - Projected Benefit Expense Development

Appendix 3 - 2024 Capitation Rate Development

State Fiscal Year 2024 Risk Adjustment Medicaid Managed Care Program (08/10/2023

SFY 2024 Risk Adjustment - Appendix 1

SFY 2024 Risk Adjustment - Appendix 2