Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP)

The Rhode Island Executive Office of Health and Human Services is seeking proposals to administer the Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Program, a Qualified List of Vendors (QLV) solicitation with proposals due November 4, 2026 and a non-mandatory pre-bid conference on October 15, 2026. Vendors must meet a minimum 10% dollar-value participation requirement by certified minority and women-owned businesses. Vendor questions are due October 16, 2026.

The program serves approximately 37,060 full-benefit dual-eligible members age 21 and older entitled to Medicare Parts A and B and eligible for full Medicaid benefits. The scope encompasses plan management, member services, care coordination, and integration of medical and behavioral health services across nursing home, home and community-based services, developmentally disabled, severe and persistent mental illness, and community well populations. Covered services, population health and care management, network provider access, member experience, quality improvement, and operational readiness are all required technical proposal components.

Minimum qualifications include federal MCO status; Rhode Island HMO licensure or commitment to obtain it within 60 days of contract execution; non-exclusion status; capacity to perform all required functions; at least three consecutive years managing medical, behavioral, and long-term services and support services with a minimum of 50,000 combined Medicaid, Medicare, or Medicaid-like members; principal place of business in the United States; current NCQA or URAC accreditation; and CMS approval to execute an integrated D-SNP contract for plan year 2028. Bidders must maintain or establish a Rhode Island location within three months of award within a 25-mile radius of Cranston, Rhode Island. HIPAA Business Associate Agreements are required if applicable.

The initial contract term runs January 1, 2028 through December 31, 2028, with renewal options for up to five additional 12-month periods at the State's discretion based on performance and fund availability. The State reserves the right to award one to three bidders. A 0.33% contract administrative fee will be withheld from invoices. Bidders must maintain comprehensive insurance: general liability ($1 million per occurrence/$2 million aggregate), workers' compensation, automobile liability ($1 million), professional liability ($2 million per occurrence/$3 million aggregate), cyber/privacy liability ($20 million per occurrence/aggregate), and physical abuse and molestation liability ($1 million per occurrence). Technical proposals are scored out of 100 points with a passing threshold of 60 points; up to 6 ISBE bonus points are available. All submissions must be electronic through Ocean State Procures; mailed, faxed, emailed, or hand-delivered submissions will not be accepted.