FIDE-SNP APPENDIX A.pdf

This is Appendix A to a solicitation issued by the Rhode Island Executive Office of Health and Human Services (EOHHS) for the administration of the Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Program. The appendix establishes the operational framework and requirements for qualified bidders seeking to manage all functions related to the FIDE-SNP program, which serves dual eligible individuals—those eligible for both Medicare and Medicaid benefits. The solicitation seeks comprehensive administrative services encompassing plan management, member services, care coordination, and integration of medical and behavioral health services. Bidders must demonstrate capability to manage the full spectrum of program operations while maintaining compliance with federal Medicare Advantage and state Medicaid requirements. The document outlines specific performance standards, deliverables, and operational expectations that successful bidders must meet throughout the contract period.

The appendix details critical operational specifications, reporting requirements, and performance metrics that govern the FIDE-SNP program administration. Bidders are required to demonstrate financial stability, technical capacity, and experience managing integrated care models for vulnerable dual eligible populations. The contract establishes accountability measures including data reporting timelines, member satisfaction standards, care quality metrics, and regulatory compliance benchmarks. Funding for the program derives from Medicare capitation payments and state Medicaid contributions, with financial terms structured to incentivize quality outcomes and operational efficiency. The appendix specifies ongoing monitoring requirements, audit provisions, and corrective action protocols to ensure bidders maintain performance standards throughout the contract term.