Rhode Island Code of Regulations
Title 210 - Executive Office of Health and Human Services
Chapter 40 - Medicaid for Elders and Adults with Disabilities
Subchapter 10 - Managed Care
Part 1 - Managed Care Service Delivery Arrangements
Section 210-RICR-40-10-1.1 - Overview of this Rule

Program

Rhody Health Partners

Medicare-Medicaid Plan

PACE

Population

Elders and Adults with Disabilities who do not have Medicare or other third-party coverage; Persons without Medicare who are receiving LTSS in the home or community-based service setting, are enrolled in RHP for essential primary care services only.

Elderly and non-elderly adults who have full Medicare (Parts A, B, and D) coverage and Medicaid Health Coverage

Medicaid beneficiaries age 55 and older who qualify for a nursing home level of care

Mandatory/

Voluntary Enrollment

Mandatory

Voluntary

Voluntary

Covered Services

Medicaid

Medicaid and Medicare Parts A, B, and D

Medicaid and Medicare Parts A, B, and D (if eligible)

Participation Criteria

Age 21 and older; and

Eligible for Medicaid Health Coverage on the basis of the SSI income standard (IHCC group)

Age 21 and older;

Eligible for Medicaid Health Coverage on the basis of the SSI income standard (IHCC group) or the MAGI income standard (MACC group); and

Enrolled in Medicare Part A, enrolled in Medicare Part B, and eligible to enroll in Medicare Part D

Age 55 years and older;

Meet criteria for high or highest need for a nursing facility level of care; and

Meet all other requirements for LTSS