Part 2 - Medicaid Managed Care Delivery Options

Section 210-RICR-30-05-2.1 - RIte Care Overview
Section 210-RICR-30-05-2.2 - Scope and Purpose
Section 210-RICR-30-05-2.3 - Program Management
Section 210-RICR-30-05-2.4 - Definitions
Section 210-RICR-30-05-2.5 - Coverage Groups in RIte Care
Section 210-RICR-30-05-2.6 - Excluded Medicaid Coverage Groups
Section 210-RICR-30-05-2.7 - Retroactive Coverage
Section 210-RICR-30-05-2.8 - Overview of RIte Care Services
Section 210-RICR-30-05-2.9 - RIte Care In-Plan Capitated Benefits
Section 210-RICR-30-05-2.10 - Out-of-Plan Benefits
Section 210-RICR-30-05-2.11 - Limits on Services
Section 210-RICR-30-05-2.12 - Scope of Provider Networks
Section 210-RICR-30-05-2.13 - Mainstreaming/Selective Contracting
Section 210-RICR-30-05-2.14 - Primary Care Providers (PCPs)
Section 210-RICR-30-05-2.15 - Service Accessibility Standards
Section 210-RICR-30-05-2.16 - Mandatory Participation in Managed Care
Section 210-RICR-30-05-2.17 - Enrollment Procedures, Rights and Responsibilities
Section 210-RICR-30-05-2.18 - Rhody Health Partners - Program Overview
Section 210-RICR-30-05-2.19 - Scope and Purpose
Section 210-RICR-30-05-2.20 - Applicability
Section 210-RICR-30-05-2.21 - MACC Group in Rhody Health Partners
Section 210-RICR-30-05-2.22 - Overview of RHP
Section 210-RICR-30-05-2.23 - Access to Benefits
Section 210-RICR-30-05-2.24 - RHP In-Plan Capitated Benefits
Section 210-RICR-30-05-2.25 - SPMI Modifications
Section 210-RICR-30-05-2.26 - Out-of-Plan Benefits
Section 210-RICR-30-05-2.27 - Services that are Not Covered by Medicaid
Section 210-RICR-30-05-2.28 - Scope of Provider Networks
Section 210-RICR-30-05-2.29 - Mainstreaming/Selective Contracting
Section 210-RICR-30-05-2.30 - Primary Care Providers (PCPs)
Section 210-RICR-30-05-2.31 - Service Accessibility Standards
Section 210-RICR-30-05-2.32 - Mandatory Participation in Managed Care
Section 210-RICR-30-05-2.33 - Enrollment Procedures, Rights, and Responsibilities
Section 210-RICR-30-05-2.34 - Enrollment Processes for RIte Care and Rhody Health Partners Managed Care Plans Overview
Section 210-RICR-30-05-2.35 - Scope and Purpose
Section 210-RICR-30-05-2.36 - Initiating Enrollment: No Wrong Door
Section 210-RICR-30-05-2.37 - Enrollment of Newborns and Adopted Children
Section 210-RICR-30-05-2.38 - Medicaid Members Exempt from Enrollment Managed Care
Section 210-RICR-30-05-2.39 - MCO Lock-In
Section 210-RICR-30-05-2.40 - Open Enrollment
Section 210-RICR-30-05-2.41 - Membership Handbook
Section 210-RICR-30-05-2.42 - Identification Cards
Section 210-RICR-30-05-2.43 - Interim Fee-for-Service Coverage
Section 210-RICR-30-05-2.44 - Verification of Eligibility/Enrollment
Section 210-RICR-30-05-2.45 - Responsibility of Medicaid Members to Report Change in Status
Section 210-RICR-30-05-2.46 - Transitioning Members between MCOs and Delivery Systems
Section 210-RICR-30-05-2.47 - Grievances, Appeals, and Hearings
Section 210-RICR-30-05-2.48 - MCO Initiated Disenrollment
Section 210-RICR-30-05-2.49 - EOHHS Authority
Section 210-RICR-30-05-2.50 - Reasons for Disenrollment
Section 210-RICR-30-05-2.51 - Disenrollment Effective Dates
Section 210-RICR-30-05-2.52 - Right to Appeal
Section 210-RICR-30-05-2.53 - Medicaid Member Rights and Protections
Section 210-RICR-30-05-2.54 - Pharmacy Home Program
Section 210-RICR-30-05-2.55 - Rite Smiles Dental Plan Overview
Section 210-RICR-30-05-2.56 - Legal Authority
Section 210-RICR-30-05-2.57 - Coverage Groups
Section 210-RICR-30-05-2.58 - Excluded Coverage Groups
Section 210-RICR-30-05-2.59 - Retroactive Eligibility
Section 210-RICR-30-05-2.60 - Enrollment Process
Section 210-RICR-30-05-2.61 - Voluntary Selection of a Dental Plan
Section 210-RICR-30-05-2.62 - Auto Re-Enrollment Following Resumption of Eligibility
Section 210-RICR-30-05-2.63 - Rite Smiles Lock-In
Section 210-RICR-30-05-2.64 - Open Enrollment
Section 210-RICR-30-05-2.65 - Voluntary Disenrollment
Section 210-RICR-30-05-2.66 - Member Disenrollment
Section 210-RICR-30-05-2.67 - Information and Referral
Section 210-RICR-30-05-2.68 - Severability