Rhode Island Code of Regulations
Title 210 - Executive Office of Health and Human Services
Chapter 30 - Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 05 - Service Delivery Options
Part 2 - Medicaid Managed Care Delivery Options
Section 210-RICR-30-05-2.35 - Scope and Purpose

A. The Medicaid eligible Medicaid Affordable Care Coverage (MACC) groups identified in the "Affordable Care Coverage Groups" (Subchapter 00 Part 1 of this Chapter) must enroll for coverage in a RIte Care (families, parent/caretaker, children and pregnant women) or Rhody Health Partners (adults nineteen (19) to sixty-four (64) without children) managed care plan, as described above. There are other Medicaid coverage groups enrolled in both service delivery systems.

B. This Rule applies to all RIte Care coverage groups identified in § 2.1 of this Part. It does not apply to adults eligible on the basis of age, blindness, or disability subject to the provisions for RIte Care unless the beneficiary qualifies for and chooses the eligibility pathway for parents/caretakers. See Part 40-10-1 of this Title for a description of these groups.

C. EOHHS must ensure that enrollment in RIte Care and Rhody Health Partner (RHP) MCOs function in a timely and efficient manner that respects the rights of Medicaid eligible individuals and families and the State's interest in assuring that they have ready access to an organized system of high quality health care.

D. The provisions of this rule also apply to any applicants in these coverage groups who have access to employer-sponsored (ESI) health plans who may be qualified for the RIte Share premium assistance program, as specified in Part 3 of this Subchapter, until further notice from the EOHHS.