Integrated Care Initiative – Key Documents

The Integrated Care Initiative (ICI) is a Rhode Island pilot project to provide health coverage for dual eligibles (those with both Medicare and Medicaid) through a single health plan.  The only health plan now participating in the ICI is Neighborhood Health Plan of RI (NHP), with a product called NHP Integrity.

This page contains links to some important documents and resources about the ICI.

  • Three-Way Contract – This is the contract signed by the federal government (CMS), RI EOHHS, and NHPRI.  It governs many aspects of how the ICI and NHP Integrity plan will work.  It includes many important provisions for beneficiaries, including sections on:
    • eligibility and enrollment,
    • covered services,
    • care coordination,
    • access to services, and
    • appeals.
  • MOU CMS-EOHHS – This is the memorandum of understanding (MOU) between CMS and RI EOHHS governing the ICI.  It was completed before the three-way contact, so is likely less specific about most issues.
  • EOHHS Rule 1475 – This regulation governs the ICI and describes other coverage options for duals.
  • The Point has three counselors available for face-to-face enrollment meetings with duals who might interested in NHP Integrity.  They can be reached by calling The Point at 401-462-4444.
  • The RIPIN Healthcare Advocate is the officially designated “ombudsman program” available to help beneficiaries with questions or complaints.  They can be reached at 1-855-747-3224.

 

Author:  Sam
Created:  August 2016
Updated:

 

Healthcare Rights E-News

Updates and more for Resource Hub users Join

And financial support from: