2023 Medicaid Managed Care Procurement Library

Medicaid Managed Care Manual

Medicaid Managed Care Policy and Guidance Documents

2023

RI Medicaid Monthly Managed Care Report

• RI Medicaid Monthly Managed Care Report - 01/2023
• RI Medicaid Monthly Managed Care Report - 02/2023
• RI Medicaid Monthly Managed Care Report - 03/2023
• RI Medicaid Monthly Managed Care Report - 04/2023
• RI Medicaid Monthly Managed Care Report - 05/2023
• RI Medicaid Monthly Managed Care Report - 06/2023
• RI Medicaid Monthly Managed Care Report - 07/2023
• RI Medicaid Monthly Managed Care Report - 08/2023
• RI Medicaid Monthly Managed Care Report - 09/2023
• RI Medicaid Monthly Managed Care Report - 10/2023
• RI Medicaid Monthly Managed Care Report - 11/2023

EOHHS Auto Assignment Report

• EOHHS Auto Assignment Report - 01/2023
• EOHHS Auto Assignment Report - 02/2023
• EOHHS Auto Assignment Report - 03/2023
• EOHHS Auto Assignment Report - 04/2023
• EOHHS Auto Assignment Report - 05/2023
• EOHHS Auto Assignment Report - 06/2023
• EOHHS Auto Assignment Report - 07/2023
• EOHHS Auto Assignment Report - 08/2023
• EOHHS Auto Assignment Report - 09/2023
• EOHHS Auto Assignment Report - 10/2023
• EOHHS Auto Assignment Report - 11/2023

Termination Code Reason Report

• Termination Code Reason Report - 01/2023
• Termination Code Reason Report - 02/2023
• Termination Code Reason Report - 03/2023
• Termination Code Reason Report - 04/2023
• Termination Code Reason Report - 05/2023
• Termination Code Reason Report - 06/2023
• Termination Code Reason Report - 07/2023
• Termination Code Reason Report - 08/2023
• Termination Code Reason Report - 09/2023
• Termination Code Reason Report - 10/2023
• Termination Code Reason Report - 11/2023

2022

RI Medicaid Monthly Managed Care Report

• RI Medicaid Monthly Managed Care Report - 01/2022
• RI Medicaid Monthly Managed Care Report - 02/2022
• RI Medicaid Monthly Managed Care Report - 03/2022
• RI Medicaid Monthly Managed Care Report - 04/2022
• RI Medicaid Monthly Managed Care Report - 05/2022
• RI Medicaid Monthly Managed Care Report - 06/2022
• RI Medicaid Monthly Managed Care Report - 07/2022
• RI Medicaid Monthly Managed Care Report - 08/2022
• RI Medicaid Monthly Managed Care Report - 09/2022
• RI Medicaid Monthly Managed Care Report - 10/2022
• RI Medicaid Monthly Managed Care Report - 11/2022
• RI Medicaid Monthly Managed Care Report - 12/2022

EOHHS Auto Assignment Report 

• EOHHS Auto Assignment Report - 01/2022
• EOHHS Auto Assignment Report - 02/2022
• EOHHS Auto Assignment Report - 03/2022
• EOHHS Auto Assignment Report - 04/2022
• EOHHS Auto Assignment Report - 05/2022
• EOHHS Auto Assignment Report - 06/2022
• EOHHS Auto Assignment Report - 07/2022
• EOHHS Auto Assignment Report - 08/2022
• EOHHS Auto Assignment Report - 09/2022
• EOHHS Auto Assignment Report - 10/2022
• EOHHS Auto Assignment Report - 11/2022
• EOHHS Auto Assignment Report - 12/2022

Termination Code Reason Report

• Termination Code Reason Report - 01/2022
• Termination Code Reason Report - 02/2022
• Termination Code Reason Report - 03/2022
• Termination Code Reason Report - 04/2022
• Termination Code Reason Report - 05/2022
• Termination Code Reason Report - 06/2022
• Termination Code Reason Report - 07/2022
• Termination Code Reason Report - 08/2022
• Termination Code Reason Report - 09/2022
• Termination Code Reason Report - 10/2022
• Termination Code Reason Report - 11/2022
• Termination Code Reason Report - 12/2022

2021

RI Medicaid Monthly Managed Care Report

• RI Medicaid Monthly Managed Care Report - 01/2021
• RI Medicaid Monthly Managed Care Report - 02/2021
• RI Medicaid Monthly Managed Care Report - 03/2021
• RI Medicaid Monthly Managed Care Report - 04/2021
• RI Medicaid Monthly Managed Care Report - 05/2021
• RI Medicaid Monthly Managed Care Report - 06/2021
• RI Medicaid Monthly Managed Care Report - 07/2021
• RI Medicaid Monthly Managed Care Report - 08/2021
• RI Medicaid Monthly Managed Care Report - 09/2021
• RI Medicaid Monthly Managed Care Report - 10/2021
• RI Medicaid Monthly Managed Care Report - 11/2021
• RI Medicaid Monthly Managed Care Report - 12/2021

EOHHS Auto Assignment Report 

• EOHHS Auto Assignment Report - 01/2021
• EOHHS Auto Assignment Report - 02/2021
• EOHHS Auto Assignment Report - 03/2021
• EOHHS Auto Assignment Report - 04/2021
• EOHHS Auto Assignment Report - 05/2021
• EOHHS Auto Assignment Report - 06/2021
• EOHHS Auto Assignment Report - 07/2021
• EOHHS Auto Assignment Report - 08/2021
• EOHHS Auto Assignment Report - 09/2021
• EOHHS Auto Assignment Report - 10/2021
• EOHHS Auto Assignment Report - 11/2021
• EOHHS Auto Assignment Report - 12/2021

Termination Code Reason Report

• Termination Code Reason Report - 01/2021
• Termination Code Reason Report - 02/2021
• Termination Code Reason Report - 03/2021
• Termination Code Reason Report - 04/2021
• Termination Code Reason Report - 05/2021
• Termination Code Reason Report - 06/2021
• Termination Code Reason Report - 07/2021
• Termination Code Reason Report - 08/2021
• Termination Code Reason Report - 09/2021
• Termination Code Reason Report - 10/2021
• Termination Code Reason Report - 11/2021
• Termination Code Reason Report - 12/2021

Medicaid Expenditure Report

      SFY 2022 Medicaid Expenditure Report

      SFY 2021 Medicaid Expenditure Report

      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

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

2021 External Quality Review Report 

• 2021 Aggregate EQR Technical Report, April 2023
• 2021 Tufts EQR Technical Report, April 2023
• 2021 Neighborhood EQR Technical Report, April 2023
• 2021 UHCCP-RI EQR Technical Report, April 2023

Provider Manual and Guidelines

Fee Schedules

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

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