Official State of Rhode Island website

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The Executive Office of Health and Human Services State of Rhode Island

Medicaid Managed Care Contracts & Policy/Guidance Documents

Tufts Health Public Plan- RI Together Contract

THPP 2017-19 Amendment 19 (Full Contract)

THPP 2017-19 Standalone Amendment 19 (11/20/2025)

Previous Amendments:

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 (Full Contract)

THPP 2017-04 Standalone Amendment 4 (04/08/2021)

THPP 2017-05 Amendment 5 (Full Contract)

THPP 2017-05 Standalone Amendment 5 (10/20/2021)

THPP 2017-06 Amendment 6 (Full Contract)

THPP 2017-06 Standalone Amendment 6 (03/20/2022)

THPP 2017-07 Amendment 7 (Full Contract)

THPP 2017-07 Standalone Amendment 7 (07/13/2022)

THPP 2017-08 Amendment 8 (Full Contract)

THPP 2017-08 Standalone Amendment 8 (07/26/2022)

THPP 2017-09 Amendment 9 (Full Contract)

THPP 2017-09 Standalone Amendment 9 (09/28/2022)

THPP 2017-09B Amendment 9B (Full Contract)

THPP 2017-09B Standalone Amendment 9B (10/24/2023)

THPP 2017-10 Amendment 10 (Full Contract)

THPP 2017-10 Standalone Amendment 10 (06/15/2023)

THPP 2017-11 Amendment 11 (Full Contract)

THPP 2017-11 Standalone Amendment 11 (08/15/2023)

THPP 2017-12 Amendment 12 (Full Contract)

THPP 2017-12 Standalone Amendment 12 (10/24/2023)

THPP 2017-12B Amendment 12B (Full Contract)

THPP 2017-12B Standalone Amendment 12B (06/03/2024)

THPP 2017-13 Amendment 13 (Full Contract)

THPP 2017-13 Standalone Amendment 13 (10/24/2023)

THPP 2017-14 Amendment 14 (Full Contract)

THPP 2017-14 Standalone Amendment 14 (08/09/2024)

THPP 2017-15 Amendment 15 (Full Contract)

THPP 2017-15 Standalone Amendment 15 (11/14/2024)

THPP 2017-15B Amendment 15B (Full Contract)

THPP 2017-15B Standalone Amendment 15B (04/07/2025)

THPP 2017-16 Amendment 16 (Full Contract)

THPP 2017-16 Standalone Amendment 16 (12/16/2024)

THPP 2017-16B Amendment 16B (Full Contract)

THPP 2017-16B Standalone Amendment 16B (04/07/2025)

THPP 2017-17 Amendment 17 (Full Contract)

THPP 2017-17 Standalone Amendment 17 (05/22/2025)

THPP 2017-18 Amendment 18 (Full Contract)

THPP 2017-18 Standalone Amendment 18 (06/23/2025)

United Healthcare Community Plan of Rhode Island Contract

UHC 2017-19 Amendment 19 (Full Contract)

UHC 2017-19 Standalone Amendment 19 (11/20/2025)

Previous Amendments:

UHC 2017-01 Amendment 1 (10/03/2018

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 (Full Contract)

UHC 2017-04 Standalone Amendment 4 (04/08/2021)

UHC 2017-05 Amendment 5 (Full Contract)

UHC 2017-05 Standalone Amendment 5 (10/06/2021)

UHC 2017-06 Amendment 6 (Full Contract)

UHC 2017-06 Standalone Amendment 6 (03/29/2022)

UHC 2017-07 Amendment 7 (Full Contract)

UHC 2017-07 Standalone Amendment 7 (08/10/2022)

UHC 2017-08 Amendment 8 (Full Contract)

UHC 2017-08 Standalone Amendment 8 (08/10/2022)

UHC 2017-09 Amendment 9 (Full Contract)

UHC 2017-09 Standalone Amendment 9 (09/28/2022)

UHC 2017-09B Amendment 9B (Full Contract)

UHC 2017-09B Standalone Amendment 9B (10/24/2023)

UHC 2017-10 Amendment 10 (Full Contract)

UHC 2017-10 Standalone Amendment 10 (06/15/2023)

UHC 2017-11 Amendment 11 (Full Contract)

UHC 2017-11 Standalone Amendment 11 (08/09/2023)

UHC 2017-12 Amendment 12 (Full Contract)

UHC 2017-12 Standalone Amendment 12 (10/24/2023)

UHC 2017-12B Amendment 12B (Full Contract)

UHC 2017-12B Standalone Amendment 12B (06/03/2024)

UHC 2017-13 Amendment 13 (Full Contract)

UHC 2017-13 Standalone Amendment 13 (10/24/2023)

UHC 2017-14 Amendment 14 (Full Contract)

UHC 2017-14 Standalone Amendment 14 (08/09/2024)

UHC 2017-15 Amendment 15 (Full Contract)

UHC 2017-15 Standalone Amendment 15 (11/14/2024)

UHC 2017-15B Amendment 15B (Full Contract)

UHC 2017-15B Standalone Amendment 15B (04/07/2025)

UHC 2017-16 Amendment 16 (Full Contract)

UHC 2017-16 Standalone Amendment 16 (12/16/2024)

UHC 2017-16B Amendment 16B (Full Contract)

UHC 2017-16B Standalone Amendment 16B (04/07/2025)

UHC 2017-17 Amendment 17 (Full Contract)

UHC 2017-17 Standalone Amendment 17 (05/22/2025)

UHC 2017-18 Amendment 18 (Full Contract)

UHC 2017-18 Standalone Amendment 18 (06/23/2025)

Neighborhood Health Plan of Rhode Island- Medicaid Managed Care Plan Contract

NHPRI 2017-19 Amendment 19 (Full Contract)

NHPRI 2017-19 Standalone Amendment 19 (11/20/2025)

Previous Amendments:

NHPRI 2017-01 Amendment 1 (10/03/2018)

Base Contract, Addendums, Attachments

NHPRI 2017-02 Amendment 2 (02/15/2019)

Base Contract, Addendums, Attachments

NHPRI 2017-03 Amendment 3 (09/23/2019)

Base Contract, Addendums, Attachments

NHPRI 2017-04 Amendment 4 (Full Contract)

NHPRI 2017-04 Standalone Amendment 4 (04/20/2021)

NHPRI 2017-05 Amendment 5 (Full Contract)

NHPRI 2017-05 Standalone Amendment 5 (10/20/2021)

NHPRI 2017-06 Amendment 6 (Full Contract)

NHPRI 2017-06 Standalone Amendment 6 (03/30/2022)

NHPRI 2017-07 Amendment 7 (Full Contract)

NHPRI 2017-07 Standalone Amendment 7 (08/10/2022)

NHPRI 2017-08 Amendment 8 (Full Contract)

NHPRI 2017-08 Standalone Amendment 8 (08/10/2022)

NHPRI 2017-09 Amendment 9 (Full Contract)

NHPRI 2017-09 Standalone Amendment 9 (10/03/2022)

NHPRI 2017-09B Amendment 9B (Full Contract)

NHPRI 2017-09B Standalone Amendment 9B (10/24/2023)

NHPRI 2017-10 Amendment 10 (Full Contract)

NHPRI 2017-10 Standalone Amendment 10 (06/13/2023)

NHPRI 2017-11 Amendment 11 (Full Contract)

NHPRI 2017-11 Standalone Amendment 11 (08/09/2023)

NHPRI 2017-12 Amendment 12 (Full Contract)

NHPRI 2017-12 Standalone Amendment 12 (10/24/2023)

NHPRI 2017-12B Amendment 12B (Full Contract)

NHPRI 2017-12B Standalone Amendment 12B (06/03/2024)

NHPRI 2017-13 Amendment 13 (Full Contract)

NHPRI 2017-13 Standalone Amendment 13 (11/14/2023)

NHPRI 2017-14 Amendment 14 (Full Contract)

NHPRI 2017-14 Standalone Amendment 14 (08/09/2024)

NHPRI 2017-15 Amendment 15 (Full Contract)

NHPRI 2017-15 Standalone Amendment 15 (11/14/2024)

NHPRI 2017-15B Amendment 15B (Full Contract)

NHPRI 2017-15B Standalone Amendment 15B (04/07/2025)

NHPRI 2017-16 Amendment 16 (Full Contract)

NHPRI 2017-16 Standalone Amendment 16 (12/16/2024)

NHPRI 2017-16B Amendment 16B (Full Contract)

NHPRI 2017-16B Standalone Amendment 16B (04/07/2025)

NHPRI 2017-17 Amendment 17 (Full Contract)

NHPRI 2017-17 Standalone Amendment 17 (05/22/2025)

NHPRI 2017-18 Amendment 18 (Full Contract)

NHPRI 2017-18 Standalone Amendment 18 (06/23/2025)

United Healthcare-RIte Smiles Contract

UHC RIte Smiles Amendment 9 (Full Contract)

UHC RIte Smiles Standalone Amendment 9 (05/29/2025)

Previous Amendments:

UHC-RIte Smiles Standalone Amendment 1 (10/15/2020)

UHC RIte Smiles Amendment 2 (Full Contract)

UHC-RIte Smiles Standalone Amendment 2 (10/06/2021)

UHC RIte Smiles Amendment 3 (Full Contract)

UHC-RIte Smiles Standalone Amendment 3 (08/10/2022)

UHC RIte Smiles Amendment 4 (Full Contract)

UHC-RIte Smiles Standalone Amendment 4 (06/14/2023)

UHC RIte Smiles Amendment 5 (Full Contract)

UHC-RIte Smiles Standalone Amendment 5 (07/18/2023)

UHC RIte Smiles Amendment 6 (Full Contract)

UHC-RIte Smiles Standalone Amendment 6 (01/29/2024)

UHC RIte Smiles Amendment 7 (Full Contract)

UHC-RIte Smiles Standalone Amendment 7 (07/01/2024)

UHC RIte Smiles Amendment 8 (Full Contract)

UHC-RIte Smiles Standalone Amendment 8 (05/25/2025)

RIte Smiles Liquidated Damages Memo (06/2021)

Neighborhood Health Plan of Rhode Island Medicare/Medicaid Contract

Three Way Contract (07/01/2022)

Amendment (07/01/2023)

Medical Transportation Management Contract

MTM 2023-03 Amendment 3 (Full Contract)

MTM 2023-03 Standalone Amendment 3 (06/23/2025)

Previous Amendments:

MTM 2023-01 Amendment 1 (Full Contract)

MTM 2023-01 Standalone Amendment 1 (10/10/2023)

MTM 2023-01 Amendment 2 (Full Contract)

MTM 2023-02 Standalone Amendment 2 (07/31/2024)

MTM CAP Closure - Timely Notification of Critical Incidents (08/28/2024)

MTM CAP - Timely Notification of Critical Incidents (12/04/2023)

NEMT Dashboards

NEMT Dashboard - January 2026

NEMT Dashboard - February 2026

2025

NEMT Dashboard - January 2025

NEMT Dashboard - February 2025

NEMT Dashboard - March 2025

NEMT Dashboard - April 2025

NEMT Dashboard - May 2025

NEMT Dashboard - June 2025

NEMT Dashboard - July 2025

NEMT Dashboard - August 2025

NEMT Dashboard - September 2025

NEMT Dashboard - October 2025

NEMT Dashboard - November 2025

NEMT Dashboard - December 2025

2024

NEMT Dashboard - March 2024

NEMT Dashboard - April 2024

NEMT Dashboard - May 2024

NEMT Dashboard - June 2024

NEMT Dashboard - July 2024

NEMT Dashboard - August 2024

NEMT Dashboard - September 2024

NEMT Dashboard - October 2024

NEMT Dashboard - November 2024

NEMT Dashboard - December 2024

NEMT Quarterly Dashboard - SFY23 Quarter 3 Update (04/09/2024)

Medicaid Managed Care Policy and Guidance Documents

Rhode Island Managed Care Value-Added Services Request Form (01/01/2026)

Rhode Island Managed Care In Lieu of Services Request Form (01/01/2026)

Telemedicine Billing Guidance

Telemedicine Mandatory Minimum Codes for Medicaid Managed Care

EOHHS MCO Core Contract Requirements for Reporting and Intermediate Sanctions 2020 Policy (6/2024)

Katie Beckett Care Management FAQs (10/05/2023)

Provider Screening Project FAQs (10/04/2023)

MAPCO 2023 Information (06/23/2023)

Continued Coverage of COVID-19 Testing Services & Treatments (05/11/2023)

Terminated Member Outreach Policy (05/02/2023)

21^st Century Cures Act-Provider Screening and Enrollment Compliance Deadline for Medicaid Managed Care Organizations (MCOs) (02/27/2023)

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)

RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program (09/2021)

EOHHS MCO Core Contract Requirements for Reporting Demographic Changes 2020 Policy (09/2021)

EOHHS MCO Core Contract Requirements for Requesting In Lieu of Services (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

RI Medicaid Managed Care Quality Strategy

RI Medicaid Managed Care Quality Strategy (08-2022)

Accountable Entities Implementation Manual

PY5-PY6 Implementation Manual (03/01/2023)

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

2026 State Medicaid Agency D-SNP Agreements - Coordination Only

2026 State Medicaid Agency D-SNP Agreement RI – Blue Cross Blue Shield of Rhode Island (H4152-021)

2026 State Medicaid Agency D-SNP Agreement RI – Neighborhood Health Plan of Rhode Island (H2126-001)

2026 State Medicaid Agency D-SNP Agreement RI – Oxford Health Plans (H3113-010)

2026 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H0764-001) and 2026 State Medicaid Agency D-SNP Agreement RI – United Healthcare of New England (H2272-001 and H2272-003)

2026 State Medicaid Agency D-SNP Agreement – Fully Integrated Dual Special Needs Plan (FIDE SNP)

2026 State Medicaid Agency FIDE SNP Agreement RI – Neighborhood Health Plan of Rhode Island (H7635-001)

The RI EOHHS website uses CPT and ADA procedure codes and descriptions, which are copyrighted by the American Medical Association and American Dental Association.