Medicaid Renewals Medicaid renewals are back. For more information about renewing your coverage, please visit staycovered.ri.gov.
2024 Medicaid Managed Care Procurement Library 1. Reporting Calendar Template Draft - CY22 MCO Core Contract Reporting Calendar 2. 2019 Expenditure and Enrollment Report RI Medicaid Expenditure Report SFY2019 RI Medicaid Monthly Managed Care Report (10/2021) EOHHS Auto Assignment Report (10/2021) SFY 2022 Medicaid Managed Care Risk Adjustment 3. EOHHS Medicaid Managed Care 2021-2022 Procurement: Policy Report, 08/2021 MCO Procurement Policy Side Deck (07/25/2021) 4. Managed Care Organization Request for Proposal Financial Bidder's Packet Managed Care Organization Request for Qualification Financial Bidder's Packet 5. EOHHS Guidelines for Marketing and Members RI EOHHS Guidelines for Marketing Materials and Member Communications Medicaid Managed Care Program RIte Smiles NEMT MMP (adhoc) Attachment A - Non-discrimination Notice Attachment B - Marketing & Member Communications Request for Approval Attachment C - Notice of RI EOHHS Approval, Conditional Approval, or Rejection of Marketing & Member Communications Request for Approval 6. 1115 Demonstration Waiver Special Terms and Conditions Medicaid 1115 Demonstration Waiver STCs 7. Rhode Island Medicaid Provider Manual and Guides Medicaid Provider Manual 8. Accountable Entities Documents Attribution Guidance - 12/14/2020 Incentive Program Requirements - 12/14/2020 AE Certification Standards - 12/14/2020 Quality and Outcome Implementation Manual - 05/21/2021 Total Cost of Care Requirements - 12/14/2020 Total Cost of Care Technical Guidance - 12/14/2020 Attachment L-Accountable Entities Roadmap- Final - 11/16/2020 9. Grievances, Appeals and Program Integrity Guidelines and Templates MCO Appeals Grievance Template (09/2021) Appeals Template (10/2019) Grievances and Complaints Template (10/2020) MCO Program Integrity Template (10/2020) 10. EOHHS Managed Care Encounter Data Methodology, Thresholds and Penalties for non-compliance Rhode Island Medicaid Managed Care Encounter Data Quality Measurement, Thresholds and Penalties for Non-Compliance EOHHS 837 Companion Guide (1 of 2) EOHHS 837 Companion Guide (2 of 2) 11. RI Medicaid Fee Schedules RI Medicaid Fee Schedules 12. RI Managed Care Quality Strategy RI Medicaid Managed Care Quality Strategy - 2019 13. RFI Request for Information Stakeholder Summary RFI Request for Information Stakeholder Summary 14. RI Policy Documents/Medical Communications/One-pagers Treatment of Hepatitis C - Prior Authorization Guidelines 8/1/2021 The Telemedicine Coverage Act - signed 7/6/2021 Doula Services Community Health Worker Services 15. Medicaid Member Survey 2021 Rhode Island Medicaid Managed Care Member Survey 16. Health Equity Zones Health Equity Zones (HEZ) Initiative 17. Health System Transformation Program Social Determinants of Health Investing Strategy HSTP Social Determinants of Health Investing Strategy Final - 11/20/2020 18. Integrated Health Home Integrated Health Home